Potential Mechanisms of Acute Standing Balance Deficits After Concussions and Subconcussive Head Impacts: A Review

Subconcussion, Concussion, and Cognitive Decline: The Impact of Sports Related Collisions

“…Acute sensorimotor changes (i.e., standing balance) have also been detected in athletes that experienced a head impact that did not result clinical concussions, suggesting subconcussive injuries [ 13 , 120 , 121 ]. Balance assessments are commonplace within clinical concussion evaluations, as 30% of patients with concussions from sports related injuries exhibit acute balance problems [ 122 ].…”

“…In 2021, Qiao and colleagues sought to evaluate a link between head impact biomechanics and resulting balance deficits. They found substantial variability and inconsistencies among balance testing studies following subconcussive injuries [ 13 ]. Further research with consideration for the subtly and variety of these sensorimotor deficits in subconcussive injuries, compared to the grandiosity of the deficits in concussive injuries, is necessary.…”

“…The second variant presents with cognitive symptoms at an average of 60 and progresses to encompass mood and behavioral changes [ 12 ]. As each impact may cause mechanical loading of sensory and neural components within the head, various structures contributing to sensorimotor control of balance may also be impacted [ 13 ].…”

Towards defining biomarkers to evaluate concussions using virtual reality and a moving platform (BioVRSea)

“…Postural control assessed with the sensory organization test (SOT) following a mTBI 23 showed that those who had previously experienced a concussion displayed different postural control dynamics compared to a control group, months and up to several years after the initial injury. This relationship between concussive impacts and balance problems has been demonstrated in many studies, with targeted quantitative methods focusing on sensorimotor and neural components suggested as the next step for better understanding 122 . Given this connection between concussion and postural control, electromyographic (EMG) recordings, although not commonly used when assessing symptoms after concussion 39 , could be used to assess possible biomarkers for concussion, as they can record muscular activity necessary to maintain postural stability 42 .…”

Special Issue: Concussions

“…Last year's special issue on concussion started with two review papers that investigated potential mechanisms of acute standing balance deficits and MR imaging of human brain mechanics. 3,18 Concussions have continued to be one of the more common acute injuries attained across a variety of sports. Over the past few years, advancements in helmet technologies, instrumentation and impact reconstruction, modeling of brain biomechanics and investigation of injury risk, and the assessment of clinical outcomes have accelerated the field towards achieving the goal of concussion prevention and brain injury mitigation in sports.…”