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Influence of Age on Postconcussive Postural Control Measures and Future Implications for Assessment
Jason A Hugentobler1, Resmi Gupta, Robert Slater
1*Department of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; †Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; ‡University of Cincinnati, Cincinnati, Ohio; §Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; ¶Department of Psychology, University of Cincinnati, Cincinnati, Ohio; and ‖Center for Cognition, Action, & Perception, University of Cincinnati, Cincinnati, Ohio.
Objective:
To examine the influence of age, sex, attention-deficit hyperactivity disorder (ADHD) status, previous history of concussion, and days since injury on postconcussion postural control assessment in adolescents who have suffered a concussion.
Design:
Prospective cohort study.
Setting:
Hospital-based outpatient clinic.
Participants:
Seventy-one participants (42 males; 29 females) with mean age 14.14 ± 2.44.
Independent Variables:
Age, sex, previous concussion history, ADHD status, total and severity of postconcussion symptoms, and days since injury.
Main Outcome Measures:
Total Balance Error Scoring System score, path length, center-of-pressure (COP) area, sample entropy, and Romberg quotient.
Results:
Pearson product-moment correlation coefficients were calculated to test for potential associations between the continuous participant characteristics and the postural control variables. Spearman correlation was used to test the association between symptom severity and the postural control variables. Standard multiple regression was used to model the extent to which participant characteristics accounted for the variance in the postural sway variables. Age was significantly associated with all of the postural sway variables except COP area for the eyes open condition and sample entropy in the anterior-posterior direction for the eyes closed condition. Sex, ADHD status, and previous concussion history did not significantly predict postural control scores.
Conclusions:
Age significantly influences scores on common postconcussion postural control assessments.
Clinical Relevance:
This study demonstrates that age is a critical factor that needs to be accounted for to improve the clinical appropriateness and utility of current postconcussion postural control assessments.
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