Concussion Recovery Evaluation Using the Inertial Sensor Instrumented Y Balance Test

Area of Science:

• Sports Medicine
• Neurology
• Biomechanics

Background:

• Current sports concussion assessments lack reliability and may miss subtle sensorimotor deficits.
• Undetected deficits increase the risk of re-injury in athletes.
• The Y Balance test, when instrumented with inertial sensors, may offer a more sensitive measure of dynamic movement control.

Purpose of the Study:

• To investigate if an inertial-sensor instrumented Y Balance test can detect concussion-induced changes in dynamic movement control.
• To assess the recovery of dynamic balance in concussed athletes.
• To explore the relationship between post-injury balance metrics and return to play duration.

Main Methods:

• 226 elite athletes from Rugby Union, American football, and ice hockey were assessed using the inertial-sensor Y Balance test.
• Measures included normalized reach distance, Jerk Magnitude Root-Mean-Squared (Jerk Mag RMS), and Gyroscope Magnitude Sample Entropy (Gyro Mag SEn).
• Concussed athletes (n=17) were tested 24-48 hours post-injury and at return to play (RTP); uninjured controls (n=20) were re-tested after 6 months.

Main Results:

• Concussed athletes exhibited reduced normalized reach distance and Jerk Mag RMS 24-48 hours post-injury (Cohen's D = 0.57–1.16).
• These deficits returned to pre-injury levels by the RTP point.
• No significant performance changes were observed in uninjured controls over 6 months (Cohen's D = 0.06–0.51).
• Jerk Mag RMS 24-48 hours post-injury was significantly associated with RTP duration (R² = 0.27–0.33).

Conclusions:

• Concussed athletes demonstrate altered dynamic movement control acutely post-injury.
• Dynamic balance performance typically recovers to pre-injury levels by the time of return to play.
• The inertial-sensor Y Balance test shows potential for evaluating concussion recovery prognosis.