Use of Reactive Balance Assessments With Clinical Baseline Concussion Assessments in Collegiate Athletes.

contextCurrent clinical concussion evaluations assess balance deficits using static or dynamic balance tasks while largely ignoring reactive balance. Including a reactive balance assessment might provide a more comprehensive concussion evaluation.

objectivesTo identify redundancy in current clinical baseline assessments of concussion and determine whether reactive balance adds unique information to these evaluations.

designCross-sectional study.

settingClinical assessment. PATIENTS OR OTHER

participantsA total of 279 healthy National Collegiate Athletic Association Division I athletes. INTERVENTION(S): Two cohorts of data were collected at the beginning of the athletic season. For cohort 1 (n = 191), the Immediate Post-Concussion Assessment and Cognitive Tool, instrumented modified push and release (I-mP&R), and Balance Error Scoring System (BESS) were administered. For cohort 2 (n = 88), the I-mP&R, BESS, timed tandem gait, walking with eyes closed, and clinical reaction time were administered. MAIN OUTCOME MEASURE(S): The strengths of the relationships between the Immediate Post-Concussion Assessment and Cognitive Tool cognitive indices, mP&R clinical score, instrumented measures (BESS sway; I-mP&R time to stability, latency, and step length), BESS score, timed tandem gait, walking time to completion, and clinical reaction time were characterized.

resultsThe strongest interinstrument correlation value was between single-task time to stability from the I-mP&R and clinical reaction time but was considered weak (r = 0.35, P = .001). The mP&R and I-mP&R clinical scores were weakly associated with the other assessments.

conclusionsWeak correlations between interassessment variables indicated that little redundancy was present in the current clinical evaluations. Furthermore, reactive balance represents a unique domain of function that may improve the comprehensiveness of clinical assessments.