Assessment of visuomotor function and dynamic balance control in youth hockey players with or without previous sport-related concussion over a 70-day period

Abstract

Introduction: Balance is now recognized as a clinical domain of sport-related concussion (SRC). Currently, the Return-to-Sport (RTS) protocol does not include assessment of dynamic stability or sensorimotor integration. Our recent findings have objectively identified youth athletes with from those without a previous SRC during a dynamic visuomotor balance task. Rationale: To determine whether a visuomotor dynamic balance task can identify differences between youth hockey players with and without previous SRC over time. Methods: Youth hockey players (n=31; age=12-17 years), who reported previous SRC (CONC= 13) and no history of SRC (CONT= 18) were tested twice over 70 days. Participants stood in single support on a Nintendo Wii Balance board sampled at 100Hz and performed three Go/No-Go tasks with each non-stance foot. Five FitLights were arranged on the floor anteriorly at +60°, +30°, and 0° and were used as the Go (GREEN)/No-Go (RED) stimulus. Balance control was assessed using RMS velocity of COP (vCOP) in anterior-posterior (A/P) and medial-lateral (M/L) planes. A repeated measures mixed-ANOVA was conducted to measure differences between groups. Results: The results indicate a significant group effect for both A/P vCOP (CONC= 8.18; CONT= 11.33, F= 18.97, p <.001) and M/L vCOP (CONC= 6.21; CONT= 7.70, F= 19.73, p <.001). The results suggest that CONC consistently performed the visuomotor task more conservatively compared to CONT over time. Importance: Incorporating a visuomotor dynamic balance task can objectively identify youth athletes with previous SRC over the course of a season and can determine true readiness for return to play.