title: Tracking postural stability of young concussion patients using dual-task interference.
abstract: OBJECTIVE
  This study examined the diagnostic benefit of using dual-task interference balance testing in young concussion patients and the longitudinal changes in postural stability that occur relative to other standard clinical assessments of concussion injury.
  
  
  METHODS
  Longitudinal, case-control.
  
  
  METHODS
  Eighteen patients (16.6 (1.6)y) diagnosed with a concussion provided 22 separate ratings to characterize the severity of their current concussion-related symptoms and were evaluated for postural stability at each of four clinical visits. Twenty-six injury-free adolescents (17 (2.8)y) performed balance testing on two occasions, separated by ∼1 week.
  
  
  RESULTS
  There was a progressive decrease in self-reported symptoms from visit 1 to visit 4 (P<0.0001-0.001). A similar improvement occurred in postural stability, indicated by 95% ellipse area and velocity. However, the differences in ellipse area and velocity were significant only between visit 1 and the rest of the visits as a whole (P<0.0001-0.05). There was a significant difference between concussion patients and healthy, injury-free participants in ellipse area and velocity during visit 1. A group difference was also observed in ellipse area on visit 2, but only during the two balance tests that involved a concomitant secondary cognitive task.
  
  
  CONCLUSIONS
  Improvements in postural stability coincide with reductions in reported symptoms, though apparent recovery of these selected measures of postural stability seemingly occurs sooner. Because of the distinguishing time course of recovery indicated by dual-task interference balance testing, this type of balance testing assessment may be particularly valuable in evaluating integrated functional impairment and recovery in young concussion patients.
authors.affiliation: National Institute for Athletic Health & Performance, Sanford USD Medical Center, United States. Electronic address: jason.dorman@sanfordhealth.org.
authors.forename: Jason C
authors.initials: JC
authors.lastname: Dorman
authors.affiliation: Sanford Orthopedics & Sports Medicine, Sanford USD Medical Center, United States; Sanford School of Medicine, University of South Dakota, United States.
authors.forename: Verle D
authors.initials: VD
authors.lastname: Valentine
authors.affiliation: National Institute for Athletic Health & Performance, Sanford USD Medical Center, United States; Sanford School of Medicine, University of South Dakota, United States.
authors.forename: Thayne A
authors.initials: TA
authors.lastname: Munce
authors.affiliation: Sanford School of Medicine, University of South Dakota, United States.
authors.forename: B Joel
authors.initials: BJ
authors.lastname: Tjarks
authors.affiliation: Sanford School of Medicine, University of South Dakota, United States; Methodology and Data Analysis Center, Sanford Research, United States.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Thompson
authors.affiliation: National Institute for Athletic Health & Performance, Sanford USD Medical Center, United States; Sanford School of Medicine, University of South Dakota, United States.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Bergeron
mesh_terms: D000293:Adolescent; D001924:Brain Concussion / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D016022:Case-Control Studies; D003071:Cognition; D003943:Diagnostic Techniques, Neurological; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D064926:Neurophysiological Monitoring / Q000379:methods*; D004856:Postural Balance; D013647:Task Performance and Analysis; D015599:Trauma Severity Indices
keywords: Balance; Brain injury; Clinical assessment; Cognitive function; Injury management