Differential Sensitivity Between a Virtual Reality Balance Module and Clinically Used Concussion Balance Modalities.
OBJECTIVE
Balance assessments are part of the recommended clinical concussion evaluation, along with computerized neuropsychological testing and self-reported symptoms checklists. New technology has allowed for the creation of virtual reality (VR) balance assessments to be used in concussion care, but there is little information on the sensitivity and specificity of these evaluations. The purpose of this study is to establish the sensitivity and specificity of a VR balance module for detecting lingering balance deficits clinical concussion care.


METHODS
Retrospective case-control study.


METHODS
Institutional research laboratory.


METHODS
Normal controls (n = 94) and concussed participants (n = 27).


METHODS
All participants completed a VR balance assessment paradigm. Concussed participants were diagnosed by a Certified Athletic Trainer or physician (with 48 hours postinjury) and tested in the laboratory between 7 and 10 days postinjury. Receiver operating characteristic curves were performed to establish the VR module's sensitivity and specificity for detecting lingering balance deficits.


METHODS
Final balance score.


RESULTS
For the VR balance module, a cutoff score of 8.25 was established to maximize sensitivity at 85.7% and specificity at 87.8%.


CONCLUSIONS
The VR balance module has high sensitivity and specificity for detecting subacute balance deficits after concussive injury.


CONCLUSIONS
The VR balance has a high subacute sensitivity and specificity as a stand-alone balance assessment tool and may detect ongoing balance deficits not readily detectable by the Balance Error Scoring System or Sensory Organization Test. Virtual reality balance modules may be a beneficial addition to the current clinical concussion diagnostic battery.
*Department of Kinesiology, Penn State University, University Park, Pennsylvania; †Penn State Center for Sport Concussion Research and Services, University Park, Pennsylvania; ‡Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and §Department of Psychology, Penn State University, University Park, Pennsylvania.
Elizabeth F
EF
Teel
Michael R
MR
Gay
Peter A
PA
Arnett
Semyon M
SM
Slobounov
D000293:Adolescent; D001924:Brain Concussion / Q000175:diagnosis*; D016022:Case-Control Studies; D006801:Humans; D004856:Postural Balance; D012680:Sensitivity and Specificity; D014584:User-Computer Interface; D055815:Young Adult