Relationship between the Romberg test and the Wii fit basic balance test and cognition in athletes with concussion

Abstract

Approximately 30% of individuals with a sport-related concussion present with postural instability. Multiple clinical balance tests exist to diagnose postural instability; yet little is known about the potential relationship between these type of postural assessments and cognition post-concussion. The purpose of the current study was to assess the relationship between the Romberg test, the Wii Fit basic balance test (WBBT), and the composite scores on the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) test in a sample of athletes with concussions. Fifty five post-concussed athletes (40 males) completed the Romberg test (RT) (-/+), the WBBT, and ImPACT test. WBBT performance was operationalized as the number of successfully completed trials (of 5 trials of increasing difficulty) within 30 seconds. Pearson's and point-biserial correlations examined univariate associations among the variables. The RT and WBBT were not significantly related (r = - 0.029, p = 0.832). The RT weakly correlated with ImPACT impairment scores (r = 0.26, p = 0.041), whereas WBBT the number of trials did not (r = - 0.20, p = 0.155). The RT scores were significantly correlated with ImPACT Visual Processing Speed Score (r = 0.27, p = 0.036) and Reaction Time score (r = 0.34, p = 0.006). In contrast, WBBT trials were significantly correlated with the ImPACT Visual Memory Score (r = - 0.41, p = 0.003). These results suggest that the WBBT and RT assess unique aspects of postural control. The RT may relate directly to single sensory cognitive and motor processing, while the WBBT may relate to multi-sensory visually driven cognitive and motor processing. Clinical balance tests could point to different cognitive impairments post-concussion.