Reactive balance assessments complement clinical baseline concussion assessments in collegiate athletes.


 
 Current clinical concussion evaluations assess balance deficits using static or dynamic balance tasks while largely ignoring reactive balance. Including a reactive balance assessment in current evaluations might provide a more comprehensive concussion evaluation.
 
 
 
 The purpose of this study was to determine if redundancy exists within current clinical baseline assessments of concussion and whether reactive balance adds unique information to these evaluations.
 
 
 
 Cross Sectional Study
 
 
 
 Clinical Assessment
 
 
 
 Two cohorts of data were collected at the beginning of the athletic season from healthy NCAA Division I athletes. Within the first cohort (n = 191), correlation analyses with clinical scores and inertial measurements were run between the ImPACT (Immediate Post-Concussion Assessment and Cognitive Tool), the BESS (Balance Error Scoring System), the modified Push and Release (mP&R), and instrumented mP&R (I-mP&R) to determine the strength of a relationship between these concussion tests. Within the second cohort (n = 88), correlation analyses were run between the BESS, the mP&R, Timed Tandem Gait, Walking with eyes closed, and clinical reaction time to determine the strength of the relationship between these concussion evaluation tests.
 
 
 
 ImPACT cognitive indices, BESS and mP&R clinical score and instrumented measures (BESS sway; I-mP&R time to stability, latency, and step length), TTG and Walking time to completion, and clinical reaction time.
 
 
 
 The strongest inter-instrument correlation value was r= 0.347, which was considered a weak correlation, between clinical reaction time and single task time to stability from the I-mP&R. The I-mP&R and mP&R clinical scores were weakly associated with the other assessments.
 
 
 
 The weak correlations between inter-assessment variables indicates that there is little redundancy within the current clinical evaluations. Furthermore, reactive balance represents a unique domain of function that may improve the comprehensiveness of clinical assessments.
