Self-reported balance status is not a reliable indicator of balance performance in adolescents at one-month post-concussion

J Sci Med Sport. 2017 Nov;20(11):970-975. doi: 10.1016/j.jsams.2017.04.008. Epub 2017 Apr 22.


Objectives: To determine if self-reported balance symptoms can be used as a proxy for measures of the center of pressure (COP) to identify balance deficits in a group of concussed adolescents.

Design: Case-control.

Methods: Thirteen adolescents 1-month post-concussion who reported ongoing balance problems (Balance+), 20 adolescent 1-month post-concussion who reported no balance problems (Balance-), and 30 non-injured adolescents (control) completed a series of balance tests. Participants completed two 2-min trials standing on a Nintendo Wii Balance Board™ during which the COP under their feet was recorded: i) double-leg stance, eyes open; ii) double-leg stance, eyes closed. Participants also completed a dual-task condition combining a double-leg stance and a Stroop Colour-word test.

Results: Participants in both the Balance+ and Balance- group swayed over a larger ellipse area compared to the control group while completing the Eyes Closed (Balance+, p=0.002; Balance-, p=0.002) and Dual-Task (Balance+, p=0.001; Balance-, p=0.004) conditions and performed the Dual-Task condition with faster medio-lateral velocity (Balance+, p=0.003; Balance-, p=0.009). The participants in the Balance- group also swayed over a larger ellipse area compared to the control group while completing the Eyes Open condition (p=0.005). No significant differences were identified between the Balance+ and Balance- groups.

Conclusions: At 1-month post-concussion, adolescents demonstrated balance deficits compared to non-injured adolescents regardless of whether they reported balance problems. These results suggest that self-reported balance status might not be an accurate reflection of balance performance following a concussion in adolescents.

Keywords: Adolescent; Brain injury; Cognitive function; Injury management; Postural balance.

MeSH terms

  • Adolescent
  • Analysis of Variance
  • Brain Concussion / complications*
  • Brain Concussion / physiopathology
  • Case-Control Studies
  • Child
  • Diagnostic Techniques, Neurological
  • Female
  • Humans
  • Male
  • Postural Balance*
  • Self Report*
  • Sensation Disorders / diagnosis*
  • Sensation Disorders / physiopathology
  • Severity of Illness Index
  • Time Factors