Repetitive head impacts affect mediolateral postural sway entropy in the absence of vision following a competitive athletic season: preliminary findings

Brian Szekely¹, Sushma Alphonsa², Katelyn Grimes³, Barry Munkasy⁴, Thomas Buckley⁵, Nicholas G. Murray^{2 *}

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¹ Department of Psychology, Department of Psychology

² Department of School of Community Health Sciences, Division of Kinesiology, University of Nevada, Reno, 89557, Nevada

³ Department of Athletic, University of Richmond, 23173, Virginia

⁴ Department of Health Sciences and Kinesiology Southern University, Statesboro, Georgia

⁵ Department of Kinesiology and Applied Physiology, University of Delaware, Newark, 19713, Delaware, United States

JCTR 2020, 5(4), 197–203; https://doi.org/10.18053/jctres.05.2020S4.006

Submitted: 26 July 2019 | Revised: 20 August 2019 | Accepted: 6 January 2020 | Published: 16 April 2020

© 2020 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )

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Abstract

Background: Repetitive head impacts (RHI) have received more notice over the last decade. More sensitive measures, such as postural control have been used to evaluate if there are biomechanical changes after RHI exposure. Similar to the clinical findings, most of the studies have failed to find any signficant changes across an athletic season. However, these studies included those with a concussion history and only assessed postural control in the eyes open (EO) condition, rather than in both the EO and eyes closed (EC) conditions.

Aim: The purpose of this study was to investigate postural control changes during quiet stance following a season of RHI in Division I football athletes who did not have a prior diagnosed SRC compared to a group of non RHI athletes with no history of a diagnosed sport related concussion.

Methods: Eighteen male Division I athletes were recruited and met the inclusion criteria: 9 football athletes (RHI group) and 9 baseball athletes (CON group). All athletes performed three 30s trials while standing with feet together on a force platform during EC and EO conditions. Center of pressure data were analyzed with Sample Entropy (SampEn) in the anteroposterior (AP) and mediolateral (ML) directions. SampEn data were analyzed with a three level linear mixed effects model or the multilevel model; with the three levels being: condition, time, and group.

Results: The analysis reported no significant effect for SampEn AP, but reported a significant three-way interaction (Group by Task by Time) for SampEn ML. Specifically, SampEn ML was significantly higher for EC than EO for both groups.

Conclusions: There are postural control changes from pre- to post- season, with the main contributer being EC postural control. Thus there could be a change in the sensory reweighting dynamics due to RHI and the effect of sport.

Relevance for patients: RHI may be better assessed in the clinical setting with EC, rather than with EO. Furthermore, clinicians should include tasks that deprive sensory inputs to examine the effects of RHI.

Keywords

center of pressure

regularity subconcussive impacts

balance

mTBI

sports

Conflict of interest

All authors have no competing conflicts to disclose.

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