March 2014

Postural sway complexity may reveal evidence of concussion weeks later

In the moment: Sports medicine

By Jordana Bieze Foster

Postural sway complexity can differentiate healthy young athletes from those who are still experiencing symptoms more than six weeks after suffering a concussion, while the standard sideline test for postconcussion postural stability cannot, according to research from Cincinnati Children’s Hospital presented in February at the annual Combined Sections Meeting of the American Physical Therapy Association.

In 20 healthy athletes and 20 athletes experiencing postconcussion symptoms (mean age in both  groups, 13.25 years), investigators used a force plate to assess center of pressure motion and performed detrended fluctuation analysis of those data to determine postural sway complexity (essentially the variability of the variability of that motion). They also administered the Balance Error Scoring System (BESS) test of postural stability. A mean of 49 days since injury had elapsed in the symptomatic athletes; the BESS is typically valid for a few days after injury.

Postural sway complexity differed significantly between groups in the mediolateral direction for the eyes-open condition and in the anterior-posterior direction for the eyes-closed condition. BESS scores did not differ significantly between groups.


Quatman-Yates C, Hugentobler JA, Janiszewski B, et al. A postural sway complexity protocol for detection  of postconcussion deficits in youth. J Orthop Sports Phys Ther 2014;44(1):A61-A62.

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