Sensor-based 9-week Serial Balance Data Show Need for Individualized Baseline Profiles: Implications on Concussion Diagnosis

Abstract

Objective: The ability to accurately identify concussions and assess recovery is essential to protect individuals from experiencing negative consequences regarding premature return-to-play. To date, there is no “gold” standard of concussion diagnosis nor method to track the recovery period. Instead, clinicians rely on symptom checklists and simple tests to inform clinical decisions. However, the timing and frequency of objective measurements to screen for impairment and monitor recovery remains underexamined. This study examines the potential of a rapid (5-min) sensor-based balance measurement on a habitual (i.e., pre/post-practice) schedule to screen for concussions. Design: A pilot study using a repeated observation design. Methods: Five varsity hockey players (3 males, 2 females) were recruited for a 9-week study. Each athlete was tested prior to and after practice using an IMU, performing a modified Balance Error Scoring System (BESS) test. Results: Sampled data used to estimate individual beta distributions indicates significant individual differences in balance behaviour across a range of metrics. Conclusions: This study supports the need for individualized baseline profiles for balance in order to achieve higher accuracy and sensitivity in concussion detection. Serial, habitual testing is recommended to enable concussion detection from objective measures with higher accuracy and sensitivity during sideline assessments.