Abstract
Balance control systems involve complex systems directing muscle activity to prevent internal and external influences that destabilize posture, especially when body positions change. The computerized dynamic posturography stability score has been established to be the most repeatable posturographic measure using variations of the modified Clinical Test of Sensory Integration in Balance (mCTSIB). However, the mCTSIB is a standard group of tests relying largely on eyes-open and -closed standing positions with the head in a neutral position, associated with probability of missing postural instabilities associated with head positions off the neutral plane. Postural stability scores are compromised with changes in head positions after concussion. The position of the head and neck induced by statically maintained head turns is associated with significantly lower stability scores than the standardized head neutral position of the mCTSIB in Post-Concussion Syndrome (PCS) subjects but not in normal healthy controls. This phenomenon may serve as a diagnostic biomarker to differentiate PCS subjects from normal ones as well as serving as a measurement with which to quantify function or the success or failure of a treatment. Head positions off the neutral plane provide novel biomarkers that identify and differentiate subjects suffering from PCS from healthy normal subjects.
Highlights
Balance control systems involve complex systems that direct muscle activity to prevent internal and external influences that may destabilize posture, especially when body positions change [1].Our functional independence depends upon a postural balance, yet our ability to maintain an upright posture is customarily taken for granted [2]
We aimed to demonstrate that head positions off the neutral plane would provide novel biomarkers that would identify and differentiate subjects suffering from Post-Concussion Syndrome (PCS) from healthy normal subjects
We have demonstrated that the position of the head and than standardized head neutral position of turns the mCTSIB
Summary
Balance control systems involve complex systems that direct muscle activity to prevent internal and external influences that may destabilize posture, especially when body positions change [1]. Our functional independence depends upon a postural balance, yet our ability to maintain an upright posture is customarily taken for granted [2]. Postural integrity is obtained through the central nervous system’s integration of sensory afferents and coordinated motor activity, which is dependent upon muscle strength and response to environmental perturbations [3]. Measurement error in the quantification of balance affects outcome interpretation and the appropriate development of treatment [5]. Even if the measurements are accurate, there is no guarantee that the measurements will accurately quantify balance performance if necessary functional components are omitted or missed in the testing parameters
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