Related Experiment Video
Updated: Mar 30, 2026
Author Spotlight: Repetitive Transcranial Magnetic Stimulation Combined with Movement Observation in Cerebral Palsy
Published on: August 9, 2024
A Longitudinal Examination of Postural Impairments in Children With Mild Traumatic Brain Injury: Implications for
Tara Rhine1, Catherine Quatman-Yates, Ross A Clark
1Divisions of Pediatric Emergency Medicine (Dr Rhine), Sports Medicine (Dr Quatman-Yates), and Occupational and Physical Therapy (Dr Quatman-Yates), Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; and Faculty of Health Science, Australian Catholic University, Melbourne, Victoria, Australia (Dr Clark).
Insights
Pediatric mild traumatic brain injury (mTBI) acutely alters postural control. Children showed more rigid sway patterns with eyes closed, measurable by the Romberg quotient, indicating instability.
Area of Science:
- Pediatric neurology
- Biomechanics
- Rehabilitation science
Background:
- Mild traumatic brain injury (mTBI) is common in children.
- Postural control deficits can persist after pediatric mTBI.
- Objective measures of balance are needed to track recovery.
Purpose of the Study:
- To investigate changes in postural control following pediatric mTBI.
- To identify specific balance impairments in children after mTBI.
- To evaluate the utility of the Romberg quotient in assessing mTBI-related instability.
Main Methods:
- Prospective observational cohort study of 11 children (11-16 years) with mTBI.
- Postural control assessed using Nintendo Wii Balance Board during 2-legged stance (eyes open/closed).
- Measured center of pressure path velocity and calculated Romberg quotient at acute injury and 1-month follow-up.
Main Results:
- Children with mTBI exhibited significantly lower ultralow frequency sway velocity with eyes closed acutely post-injury (p=.02).
- The Romberg quotient was significantly lower acutely compared to 1 month post-injury (p=.007).
- Acutely, sway patterns were more rigid with eyes closed than eyes open.
Conclusions:
- Pediatric mTBI leads to acute, identifiable changes in postural control, particularly with eyes closed.
- The Romberg quotient effectively highlights postural instability in children post-mTBI.
- This measure can track recovery of balance without needing pre-injury data.
Objective:
To examine how postural control changes following pediatric mild traumatic brain injury.
Setting:
Urban pediatric emergency department.
Participants:
Children 11 to 16 years old who presented within 6 hours of sustaining mild traumatic brain injury.
Design:
Prospective observational cohort followed for 1 month.
Main Measures:
Total center of pressure path velocity and path velocity within distinct frequency bands, ranging from moderate to ultralow, were recorded by the Nintendo Wii Balance Board during a 2-legged stance. Measurements were recorded in 2 separate tests with eyes open and closed. The scores of the 2 tests were compared, and a Romberg quotient was computed.
Results:
Eleven children were followed for 1 month postinjury. The ultralow frequency, which reflects slow postural movements associated with exploring stability boundaries, was lower (p = .02) during the eyes closed stance acutely following injury. The Romberg quotient for this frequency was also significantly lower acutely following injury (p = .007) than at 1 month.
Conclusion:
Following mild traumatic brain injury, children acutely demonstrate significantly more rigid sway patterns with eyes closed than with eyes open, which were highlighted by the Romberg quotient. The Romberg quotient could allow for accurate identification and tracking of postural instability without requiring knowledge of preinjury balance ability.
More Related Videos
07:02An Investigation of the Effects of Sports-related Concussion in Youth Using Functional Magnetic Resonance Imaging and the Head Impact Telemetry System
Published on: January 12, 2011
08:27Development of an Uncomplicated Mild Traumatic Brain Injury Model Modified by Weight-Drop Method and Evidenced by Magnetic Resonance Imaging
Published on: April 11, 2025