Recovery Trajectory of Postural Control Impairments Following a Concussion: A Case Study

Abstract

Context: Altered postural control represents one of the most common motor consequences following a concussion and there is a paucity of data monitoring the recovery trajectory that identifies the persistent changes of postural control. Objective: To determine whether the recovery trajectory of postural control was consistent across different measures of postural stability and whether increased postural challenge (ie, sloped surface) revealed subtle postural impairments. Design: A single-subject case study. Setting: Research laboratory. Patients or Other Participants: One concussed individual with a cohort of healthy controls (n = 10) used for comparison. Main Outcome Measures: Center of pressure variability (linear—SD and nonlinear—multiscale entropy) was used to index postural sway preinjury and at periodic intervals following the concussion. Results: The concussed individuals displayed reduced amounts of sway during the initial recovery phase that failed to returned to preinjury levels but reached the level of healthy controls at 1-month postinjury. The multiscale entropy analysis revealed increased center of pressure irregularity throughout recovery that persisted up to 1-month post injury. Conclusions: The findings identified subtle, persistent postural control impairments revealed through the nonlinear analysis of center of pressure and supports the notion that the consequences of a concussion (ie, impaired postural control) need to be considered beyond the resolution of behavioral symptoms.