Background A growing body of evidence suggests athletes may be over two times more likely to sustain a musculoskeletal (MSK) injury following concussion, highlighting significant clinical need to understand the pathophysiological changes in function and guide long term management of these patients. Reduced somatosensory function is considered one potential influencing factor for this phenomenon, whereby decreased postural control and bodily awareness leads to poor technique or abnormal movement strategies

Objective Using a measure of postural sway (Sway medical app, SMBA) and a balance assessment marker (Y-balance)this study aims to establish if somatosensory function is reduced at the point or return to play in a group of elite athletes.

Design Observational cohort study

Setting British Olympic network

Patients (or Participants) Men’s and Women’s Great Britain boxing, skeleton and hockey and elite women’s rugby

Interventions (or Assessment of Risk Factors) Baseline SMBA and Y-balance measures were taken as part of a bi-annual squad profiling battery.

Concussion was diagnosed by one of the team physiotherapists or sports medicine consultants. Testing was repeated within three days of initial injury (where possible) and upon clearance for return to play following completion of the return-to-play protocol.

Main Outcome Measurements Postural sway (SMBA) and the Y-balance test

Results To date five concussions have been recorded across all groups, demonstrating a mean percentage reduction in postural sway of 18.3% (87.2 SD = 11.3 - 71.2 SD = 23.7). Ther was no significant difference in baseline postural sway between the concussed and non-concussed groups (p=0.204).

For Y-balance, a 0.6% drop in return to play (RTP) reach was recorded in the concussed group when compared to group baseline scores (p=0.852, mean baseline- 96.3cm SD = 2.3, RTP 95.7cm SD = 3.94).

Conclusions This study highlights a trend towards a residual reduction in somatosensory function upon return to play following concussion, despite normalisation of symptoms and SCAT5 testing. Despite this not being a statistically significant change, the study offers a promising start to warrant further investigation of somatosensory function and its relationship with increased MSK injury rates.