Effect of Training Level on a Visuomotor Balance Task in Youth with Previous Sport-Related Concussion.

Abstract

INTRODUCTION: The demands of sport require the integration of cognition and sensory inputs to produce more complex, goal-directed movement. Howell and colleagues (1) revealed that the differences in balance control between athletes with or without previous concussion were greater in youth compared young adults during dual-task gait. PURPOSE: 1) To determine if a novel visuomotor dynamic balance task can objectively identify differences between youth hockey players with/without sport-related concussion (SRC); and 2) If there are balance control differences between players who participate in minor hockey and private hockey academy training. METHODS: Youth hockey players (N=47; age=12-17 years), who reported previous SRC (n=17) and CONTROL (n=30). Group 1 was from a minor hockey team (SRC1=4; CONTROL1=12) and group 2 a private hockey academy (SRC2=13, CONTROL2=18). Participants stood in single support on a Nintendo Wii Balance board sampled at 100Hz and performed a lower limb reaching task with their non-stance foot. Five FitLights were arranged on the floor anteriorly at +60°, +30°, and 0° and were used as Go(GREEN)/No-Go(RED) stimuli. Balance control was assessed using RMS velocity of COP (vCOP) in anterior-posterior (A/P) and medial-lateral (M/L) planes. RESULTS: There were significant differences for both A/P vCOP (SRC= 8.04cm/s; CONTROL= 11.04cm/s, p <.05) and M/L vCOP (SRC= 6.27cm/s; CONTROL= 7.72cm/s, p <.05), as the SRC group performed the task slower than CONTROL There were no significant differences between SRC1 and SRC2 in vCOP A/P (p=0.50) or M/L (p=0.26) likewise for CONTROL1 and CONTROL2 vCOP A/P (p=0.88) and M/L (p=0.97). CONCLUSION: The assessment of a visuomotor dynamic balance task can objectively identify youth athletes with previous history of SRC regardless of training levels. Incorporating cognitive-motor tasks may help to improve balance control deficits in youth post-SRC and ensure true readiness for return-to-sport. 1. Howell DR, Osternig LR, Chou LS. Adolescents demonstrate greater gait balance control deficits after concussion than young adults. The American journal of sports medicine. 2015 Mar;43(3):625-32.