Background: Concussion assessments rely on a multifaceted approach where evaluation of balance and postural control plays an important role. Following a concussion, 67% of individuals report dizziness as a persistent symptom and 30% experience balance impairments. Studies incorporating the common Balance Error Scoring System (BESS) tool suggest that these impairments return to pre-injury baselines within ten days of incident. In contrast, however, studies incorporating more advanced posturography methods observe significant differences in balance up to one year following injury. While the BESS is consistently associated with low sensitivity and poor reliability scores, advanced posturography systems using force plates are not practical or accessible in most recreational sports environments. Recently, the Wii Balance Board (WBB) has been identified as a potential force plate proxy. Research confirms that the WBB is both valid and reliable in collecting center of pressure data. Thus, the WBB may be useful for investigating post-concussion balance deficits. Objective: The purpose of this study was to investigate the potential utility of a customized WBB program to assess postural balance in an athletic population. The study aimed to assess change in postural balance using the clinical BESS and WBB assessment tools to evaluate balance at fixed intervals during a regular athletic season and following concussion. Design: Prospective partial cohort. Methods: Balance was assessed at baseline, mid-, and post-season. Individuals who sustained a concussion during the study period were further assessed weekly for four weeks post-injury. Results: No significant differences were observed in raw BESS scores across regular season or post-concussion time points. In contrast, significant differences in several WBB outcome measures were observed. In the single stance condition, COPML worsened by 24% and COPT worsened by 9% between baseline and post-season time points (p=.002 and p=.007). In contrast, participants improved by 14% on a timed dynamic task (p=.003) between baseline and post-season time points. Following concussion, only the WBB dynamic outcome measures were found to be statistically significant. A positive trend was observed post-concussion, suggesting that a learning effect exists with the dynamic WBB program. Conclusion: Study results emphasize the importance of considering the progression of athletic season when interpreting baseline and post-concussion balance measurements. Study results support the use of a quantitative balance assessment, such as with a WBB, to improve measurement of static and dynamic postural balance. / Graduate / 0566 / hilarymcullen@gmail.com
| Identifer | oai:union.ndltd.org:uvic.ca/oai:dspace.library.uvic.ca:1828/8204 |
| Date | 31 May 2017 |
| Creators | Cullen, Hilary, M |
| Contributors | Zehr, E. Paul, Christie, Brian, R |
| Source Sets | University of Victoria |
| Language | English, English |
| Detected Language | English |
| Type | Thesis |
| Rights | Available to the World Wide Web, http://creativecommons.org/licenses/by-nc-nd/2.5/ca/ |
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