Taken together, these findings suggest a state of hypoexcitability that persists beyond the immediate acute phase of a concussion and may result in neuromuscular impairments that would call to question the athlete's readiness to return to sport.
Limit cycle oscillations (LCOs) are a hallmark of dynamic instability in time-delayed and nonlinear systems such as climate change models, biological oscillators, and robotics. Here we study the links between the human neuromuscular system and LCOs in standing posture. First, we demonstrate through a simple mathematical model that the observation of LCOs in posture is indicative of excessive neuromuscular time-delay. To test this hypothesis we study LCOs in the postural sway of individuals with multiple sclerosis and concussed athletes representing two different populations with chronically and acutely increased neuromuscular time-delays. Using a wavelet analysis method we demonstrate that 67% of individuals with multiple sclerosis and 44% of individuals with concussion exhibit intermittent LCOs; 8% of MS-controls, 0% of older adults, and 0% of concussion-controls displayed LCOs. Thus, LCOs are not only key to understanding postural instability but also may have important applications for the detection of neuromuscular deficiencies.
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