Concussion, Postural Control, and Lower Extremity Injury Risk: A Comparison of Postural Control Tests

Area of Science:

• Sports Medicine
• Neurology
• Biomechanics

Background:

• Sports-related concussion (SRC) can lead to persistent postural control deficits.
• These deficits may increase the risk of lower extremity musculoskeletal (LEMSK) injuries.
• Inconsistent assessment methods contribute to mixed findings in current research.

Purpose of the Study:

• To investigate postural control in athletes with a history of SRC.
• To identify which postural assessment tools best predict LEMSK injury.
• To evaluate the utility of dual-task vs. single-task assessments.

Main Methods:

• Cross-sectional study of 110 NCAA Division II student-athletes (67 SRC history, 43 controls).
• Baseline postural control assessed using Balance Error Scoring System (BESS; single/dual-task), Modified Clinical Test of Sensory Interaction in Balance (M-CTSIB), and tandem gait test (TGT; single/dual-task).
• LEMSK injuries monitored over one season; logistic regression used for prediction analysis.

Main Results:

• BESS dual-task performance significantly predicted LEMSK injury (b = 0.045, p = 0.047).
• BESS single-task performance showed a trend toward significance (b = 0.054, p = 0.056).
• M-CTSIB and TGT (single/dual-task) did not significantly predict injury.

Conclusions:

• BESS dual-task performance is the most sensitive predictor of LEMSK injury among tested methods.
• Dual-task postural control testing may be valuable for identifying athletes at elevated risk post-SRC.
• This emphasizes the importance of dynamic, multi-tasking assessments in concussion management.