Johnston William, Coughlan Garrett F, Caulfield Brian
From the Insight Centre for Data Analytics, University College Dublin, Belfield, Dublin, Ireland
School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin, Ireland.
QJM. 2017 Dec;110(12):779-783. doi: 10.1093/qjmed/hcw228. Epub 2016 Dec 30.
The assessment and management of sports-related concussion has become a contentious issue in the field of sports medicine. The current consensus in concussion evaluation involves the use of a subjective examination, supported by multifactorial assessment batteries designed to target the various components of cerebral function. Balance assessment forms an important component of this multifactorial assessment, as it can provide an insight into the function of the sensorimotor subsystems post-concussion. In recent times, there has been a call to develop objective clinical assessments that can aid in the assessment and monitoring of concussion. However, traditional static balance assessments are derived from neurologically impaired populations, are subjective in nature, do not adequately challenge high functioning athletes and may not be capable of detecting subtle balance disturbances following a concussive event. In this review, we provide an overview of the importance of assessing motor function following a concussion, and the challenges facing clinicians in its assessment and monitoring. Additionally, we discuss the limitations of the current clinical methods employed in balance assessment, the role of technology in improving the objectivity of traditional assessments, and the potential role inexpensive portable technology may play in providing objective measures of more challenging dynamic tasks.
与运动相关的脑震荡的评估与管理已成为运动医学领域一个有争议的问题。目前脑震荡评估的共识是采用主观检查，并辅以旨在针对脑功能各个组成部分的多因素评估组合。平衡评估是这种多因素评估的一个重要组成部分，因为它可以洞察脑震荡后感觉运动子系统的功能。近年来，人们呼吁开发能够辅助脑震荡评估和监测的客观临床评估方法。然而，传统的静态平衡评估源自神经功能受损人群，本质上具有主观性，无法充分挑战高功能运动员，并且可能无法检测到脑震荡事件后细微的平衡障碍。在本综述中，我们概述了脑震荡后评估运动功能的重要性，以及临床医生在其评估和监测中面临的挑战。此外，我们讨论了当前平衡评估中使用的临床方法的局限性、技术在提高传统评估客观性方面的作用，以及廉价便携式技术在提供更具挑战性的动态任务的客观测量方面可能发挥的潜在作用。
