Examining Balance in College Athletes: Effects of Contact Sport and Concussion Status
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OBJECTIVE: To investigate static balance differences in college athletes based on history and timing of sports-related concussion (SRC), while considering sport impact type (contact/noncontact). DESIGN: Prospective cohort study. SETTING: Tertiary academic center. PARTICIPANTS: Collegiate athletes (contact/noncontact) were recruited and stratified across 3 groups: (1) acute, (2) chronic, and (3) nonconcussed. INTERVENTIONS: Static balance testing. MAIN OUTCOME MEASURES: Balance data were assessed using a force plate that measured mediolateral sway (ML), anteroposterior sway (AP), and path velocity (PV). Each metric was assessed under 4 different positions: eyes open feet together, eyes closed feet together, eyes open tandem, eyes closed tandem. RESULTS: Contact versus noncontact sport athletes demonstrated significant difference in PV after Bonferroni correction (P = 0.009, η2 = 0.135). Secondary pair-wise analysis demonstrated significant differences on all 4 balance conditions. There were no significant differences in average ML or AP sway based on sport impact type. Multiple linear regression demonstrated that balance metrics were significantly related to concussion symptom severity after Bonferroni correction (Adj R2 = 0.213, P = 0.010; ML sway [std B = -0.679, P = 0.003]; AP sway [std B = 0.847, P = 0.0001]; PV [std B = 0.042, P = 0.792]). There were no statistically significant effects on average PV, ML, or AP sway based on concussion history/timing alone. CONCLUSIONS: Static balance was most influenced by sport impact type with contact athletes demonstrating reduced PV and ML sway. This highlights the importance of understanding each individual athlete and their respective sport when interpreting balance data and considering return to play after SRC.