Repetitive head impacts affect mediolateral postural sway entropy in the absence of vision following a competitive athletic season: preliminary findings

Abstract

Repetitive head impacts (RHIs) have received more notice over the past decade. More sensitive measures, such as postural control, have been used to evaluate if there are biomechanical changes after RHI exposure. Similar to the clinical findings, most of the studies have failed to find any significant changes across an athletic season. However, these studies included those with a concussion history and only assessed postural control in the eyes open (EO) condition, rather than in both the EO and eyes closed (EC) conditions. The purpose of this study was to investigate postural control changes during quiet stance following a season of RHI in Division I football athletes who did not have a prior diagnosed signet ring cell compared to a group of non-RHI athletes with no history of a diagnosed sport-related concussion. Eighteen male Division I athletes were recruited and met the inclusion criteria: Nine football athletes (RHI group) and nine baseball athletes (CON group). All athletes performed three 30 s trials while standing with feet together on a force platform during EC and EO conditions. Center of pressure data was analyzed with sample entropy (SampEn) in the anteroposterior (AP) and mediolateral (ML) directions. SampEn data were analyzed with a three-level linear mixed effects model or the multilevel model, with the three levels being condition, time, and group. The analysis reported no significant effect for SampEn AP, but reported a significant three-way interaction (Group by Task by Time) for SampEn ML. Specifically, SampEn ML was significantly higher for EC than EO for both groups. There are postural control changes from pre- to post-season, with the main contributor being EC postural control. Thus, there could be a change in the sensory reweighting dynamics due to RHI and the effect of sport. RHI may be better assessed in the clinical setting with EC, rather than with EO. Furthermore, clinicians should include tasks that deprive sensory inputs to examine the effects of RHI.