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

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.