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Quantification of postural control deficits in patients with recent concussion: an inertial-sensor based approach
  1. Cailbhe Doherty1,
  2. Brian Caulfield1,
  3. John Ryan2,
  4. Yusuke Komaba3,
  5. Akihiro Inomata3,
  6. Liang Zhao1
  1. 1Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland
  2. 2St. Vincent’s University Hospital, Dublin, Ireland
  3. 3Fujitsu Laboratories Ltd, Japan


Objective To quantify postural control ability in a group with concussion compared with a ‘healthy’ control group.

Design Case-control study.

Setting University Biomechanics Laboratory.

Participants Fifteen concussion patients (4 females, 11 males) and a group of fifteen age- and sex- matched controls. Participants were excluded if they had any: lower extremity injury that may affect gait; history of cognitive deficiencies; history of ≥3 previous concussions; loss of consciousness following the concussion for >1 minute; a previously documented concussion in the previous year

Independent variable Group; Task (3 stance variants of the Balance Error Scoring System [BESS])

Outcome measures Sway area as computed using a force-plate and sway volume as computed from an accelerometer placed on the sacrum during performance of the BESS.

Main results Concussed patients exhibited increased sway area (1500 mm2 [95% CI: 900 to 2000 mm2] vs 650 mm2 [95% CI: 520 to 780 mm2] p=0.02) and sway volume (9.5 m3s–6 [95%CI: 8 to 20 m3s–6] vs 2.80 m3s–6 [95% CI: 1.8 to 3.6 m3s–6]) in the bilateral stance position of the BESS. The sway volume metric also had excellent accuracy in identifying task ‘errors’ (tandem stance: 95% CI: 80–96%, p<0.001; unilateral stance: 95% CI: 85–95%, p<0.001).

Conclusions Individuals with concussion display increased postural sway during bilateral stance. The sway volume that was calculated from the accelerometer data not only differentiated a group with concussion from a healthy control group, but successfully identified when task errors had occurred. This may be of value in the development of a pitch-side assessment system for concussion.

Competing interests None.

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