title: Associations among self-reported balance problems, post-concussion symptoms and performance-based tests: a longitudinal follow-up study.
abstract: OBJECTIVE
  The main objectives of this study were to describe long-term self-reported balance problems and to explore their associations with post-concussion symptoms and performance-based tests.
  
  
  METHODS
  Prospective study of patients with mild traumatic brain injury (MTBI). Self-reported balance problems and post-concussion symptoms were measured with the Rivermead Post-concussion Symptoms Questionnaire at 1 and 4 years after injury. Performance-based tests were performed 4 years after injury and included posturography, the Dynamic Gait Index (DGI), walking speed tests, and the six-minute walk test.
  
  
  RESULTS
  Self-reported balance problems were reported in 31% of patients 4 years after injury and correlated significantly with post-concussion symptoms. The correlations with performance-based tests varied from ρ = 0.18 to ρ = 0.70 and were strongest for the maximum walking speed test (ρ = 0.70) and a dual-task test (ρ = 0.43). The DGI had a considerable ceiling effect.
  
  
  CONCLUSIONS
  Balance problems were long-term consequences of MTBI in one third of this study sample. Self-reported balance problems correlated with post-concussion symptoms and some of the performance-based tests. Future research needs to develop and evaluate appropriate rehabilitation strategies that also address the balance problems.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Oslo University Hospital HF, Oslo, Norway. ingerid.kleffelgard@oslo-universitetssykehus.no
authors.forename: Ingerid
authors.initials: I
authors.lastname: Kleffelgaard
authors.forename: Cecilie
authors.initials: C
authors.lastname: Roe
authors.forename: Helene L
authors.initials: HL
authors.lastname: Soberg
authors.forename: Astrid
authors.initials: A
authors.lastname: Bergland
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D038223:Post-Concussion Syndrome / Q000150:complications* / Q000175:diagnosis; D004856:Postural Balance; D011446:Prospective Studies; D011597:Psychomotor Performance; D057566:Self Report; D011795:Surveys and Questionnaires; D013997:Time Factors; D016138:Walking; D055815:Young Adult