Postural control deficits identify lingering post-concussion neurological deficits

作     者：Thomas A.Buckley Jessie R.Oldham Jaclyn B.Caccese 

作者机构：Department of Kinesiology andApplied Physiology Interdisciplinary Program in Biomechanics and Movement Science 150 Human Performance Laboratory University of Delaware Newark DE 19716 USA Interdisciplinary program in Biomechanics and Movement Science University of Delaware Newark DE 19716 USA 

出 版 物：《Journal of Sport and Health Science》 (运动与健康科学（英文）)

年 卷 期：2016年第5卷第1期

页      面：61-69页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：NIH/NINDS grant (No.1R15NS070744-01A1) 

主　　题：Balance Concussion Mild traumatic brain injury Postural control Variability 

摘      要：Concussion,or mild traumatic brain injury,incidence rates have reached epidemic levels and impaired postural control is a cardinal *** purpose of this review is to provide an overview of the linear and non-linear assessments of post-concussion postural *** current acute evaluation for concussion utilizes the subjective balance error scoring system(BESS) to assess postural *** the sensitivity of the overall test battery is high,the sensitivity of the BESS is unacceptably low and,with repeat administration,is unable to accurately identify *** measures of postural control,utilizing traditional linear assessments,have identified impairments in postural control well beyond BESS *** assessments of quiet stance and gait have identified lingering impairments for at least 1 month ***,the application of non-linear metrics to concussion recovery have begun to receive limited attention with the most commonly utilized metric being approximate entropy(Ap En).Ap En,most commonly in the medial-lateral plane,has successfully identified impaired postural control in the acute post-concussion timeframe even when linear assessments of instrumented measures are equivalent to healthy pre-injury values;unfortunately these studies have not gone beyond the acute phase of *** study has identified lingering deficits in postural control,utilizing Shannon and Renyi entropy metrics,which persist at least through clinical recovery and return to ***,limited evidence from two studies suggest that individuals with a previous history of a single concussion,even months or years prior,may display altered Ap En ***,non-linear metrics provide a fertile area for future study to further the understanding of postural control impairments acutely post-concussion and address the current challenge of sensitive identification of recovery.