Associations among self-reported balance problems, post-concussion symptoms and performance-based tests: a longitudinal follow-up study

Disabil Rehabil. 2012;34(9):788-94. doi: 10.3109/09638288.2011.619624. Epub 2011 Dec 9.


Purpose: The main objectives of this study were to describe long-term self-reported balance problems and to explore their associations with post-concussion symptoms and performance-based tests.

Method: Prospective study of patients with mild traumatic brain injury (MTBI). Self-reported balance problems and post-concussion symptoms were measured with the Rivermead Post-concussion Symptoms Questionnaire at 1 and 4 years after injury. Performance-based tests were performed 4 years after injury and included posturography, the Dynamic Gait Index (DGI), walking speed tests, and the six-minute walk test.

Results: Self-reported balance problems were reported in 31% of patients 4 years after injury and correlated significantly with post-concussion symptoms. The correlations with performance-based tests varied from ρ = 0.18 to ρ = 0.70 and were strongest for the maximum walking speed test (ρ = 0.70) and a dual-task test (ρ = 0.43). The DGI had a considerable ceiling effect.

Conclusions: Balance problems were long-term consequences of MTBI in one third of this study sample. Self-reported balance problems correlated with post-concussion symptoms and some of the performance-based tests. Future research needs to develop and evaluate appropriate rehabilitation strategies that also address the balance problems.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Exercise Test*
  • Female
  • Follow-Up Studies
  • Hospitals, University
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Post-Concussion Syndrome / complications*
  • Post-Concussion Syndrome / diagnosis
  • Postural Balance*
  • Prospective Studies
  • Psychomotor Performance
  • Self Report
  • Surveys and Questionnaires
  • Time Factors
  • Walking*
  • Young Adult