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Updated: Apr 28, 2026

Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion
Published on: January 20, 2019
Validation of a virtual reality balance module for use in clinical concussion assessment and management
Elizabeth F Teel1, Semyon M Slobounov
1*Department of Kinesiology, Penn State University, University Park, Pennsylvania; and †Penn State Center for Sport Concussion Research and Services, University Park, Pennsylvania.
Objective:
To determine the criterion and content validity of a virtual reality (VR) balance module for use in clinical practice.
Design:
Retrospective, VR balance module completed by participants during concussion baseline or assessment testing session.
Setting:
A Pennsylvania State University research laboratory.
Participants:
A total of 60 control and 28 concussed students and athletes from the Pennsylvania State University.
Interventions:
None.
Main Outcome Measures:
This study examined: (1) the relationship between VR composite balance scores (final, stationary, yaw, pitch, and roll) and area of the center-of-pressure (eyes open and closed) scores and (2) group differences (normal volunteers and concussed student-athletes) on VR composite balance scores.
Results:
With the exception of the stationary composite score, all other VR balance composite scores were significantly correlated with the center of pressure data obtained from a force platform. Significant correlations ranged from r = -0.273 to -0.704 for the eyes open conditions and from r = -0.353 to -0.876 for the eyes closed condition. When examining group differences on the VR balance composite modules, the concussed group did significantly (P < 0.01) worse on all measures compared with the control group.
Conclusions:
The VR balance module met or exceeded the criterion and content validity standard set by the current balance tools and may be appropriate for use in a clinical concussion setting.
Clinical Relevance:
Virtual reality balance module is a valid tool for concussion assessment in clinical settings. This novel type of balance assessment may be more sensitive to concussion diagnoses, especially later (7-10 days) in the recovery phase than current clinical balance tools.
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