Effects of Concussions on Balance: A Systematic Review

Purpose: Concussions can cause many disturbances and or issues to the body whether it be mental or physical. Therefore, the purpose of this review is to identify how balance can be disturbed during and throughout rehabilitation with people suffering from concussions via center of pressure measurements. Methods: Only one database was used in searching for articles related to this topic, which was PubMed published from 2013 to present. For studies to be eligible they were peer reviewed research on the use of center of pressure to measure differences in balance measurements between concussed and non-concussed. No restrictions for age, ethnicity, language, or gender in this review. Research that included multiple balance measurements either than center of pressure, along with meta-analysis or systematic reviews were excluded. Studies identified and used in this review were screened for inclusion criteria/ eligibility by 1 independent reviewer extracting the data. Measurements were for balance using center of pressure, this means the use of postural sway, root mean square, and velocity of sway in sagittal and frontal planes of motion. With 90 records identified though the search phrase in PubMed, only 7 were included in this review. All studies used center of pressure measurements of postural sway, velocity, and root mean square to measure balance with a control group (non-concussed) and concussed group. Results: Center of pressure displacement (postural sway) in the sagittal and frontal planes of motion showed no definitive differences between the control and concussed groups for sagittal and frontal planes (Control: A/P= 11.4mm, M/L= 9.4mm, Concussed: A/P= 11.1mm, M/L= 8.87mm). Center of pressure postural sway velocity (mm/s) showed an increased velocity in postural sway for the sagittal plane for the concussed group (Controlled: A/P ave.= 10.73mm/s, M/L ave.= 8.8mm/s, Concussed: A/P ave.= 10.74mm/s, M/L ave.= 11.35). Center of pressure root mean square measurements showed an increased RMS for the sagittal plane for the concussed group (Controlled: A/P ave.= 7.8mm, M/L ave.= 6.2mm, Concussed: A/P ave.= 6.73mm, M/L ave.= 7.5mm). This means that the biggest differences notice for all measurement were in the sagittal plane (medial and lateral), but still no significant difference noted. Conclusions: Concussions can cause many impairments to the person both mentally and cognitively. For this review the biggest changes were with the sagittal plane of motion for postural sway velocity and root mean square. The rest was not significant enough to note a big enough difference. Key Words: Concussion, mild traumatic brain injury (mTBI), center of pressure (COP), balance, root mean square (RMS), and postural sway