Assessment of the Wii Basic Balance Test in measuring postural deficits post-concussion

Background and Aim: To evaluate the Wii Basic Balance Test (WBBT), as a tool for detecting postural instability in athletes with concussions. Methods: Seventy-nine healthy physically active controls (NORM) (mean age 21.23 ± 1.78), and fifty-six athletes with concussions (CONC) (mean age 19.39 ± 2.145) participated in this study. All participants performed the Wii Basic Balance Test, which requires the participants to shift weight mediolaterally to maintain a red bar within a blue area denoted on the screen for three seconds during set levels of difficulty. CONC were included in the study within 24-48 hours of the initial concussion injury. Seven one-way ANOVAs assessed differences for each (1) Mean total number of WBBT Levels completed (TL), (2) Mean total seconds to complete all WBBT Level (TT), (3) Time to complete Level 1 (LI), (4) Time to complete Level 2 (L2), (5) Time to complete Level 3 (L3), (6) Time to complete Level 4 (L4), (7) Time to complete Level 5 (L5). Results: CONC completed significantly fewer Levels of the WBBT (p=0.032) when compared to NORM. Athletes with Concussions took a significantly longer time to complete LI (p=0.002) when compared to CONC. Post-hoc Chi-Square analysis determined a significantly greater (p=0.015) proportion (39%) of CONC successfully completed WBBT L5 when compared to the proportion (19%) of CONC. Follow up ROC curves revealed an Sn = 0.392 and an Sp = 0.821 for TL with a cutoff value of 4 levels, Sn=0.875 and an Sp = 0.253 for LI with a cutoff value of 4.4 seconds, and Sn = 0.804 and an Sp = 0.392 for those who successfully completed the WBBT L5. Conclusions: WBBT could be a low cost object method of assessing postural instability within 24-48 hours post-concussion. Relevance for patients: This data could provide health providers with an alternative method to measure the presence of postural instability post-concussion injury.