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

Abstract 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