Feigenbaum Luis A, Kim Kyoung J, Gaunaurd Ignacio A, Kaplan Lee D, Scavo Vincent A, Bennett Christopher, Gailey Robert S
UHealth Sports Medicine Institute, University of Miami Miller School of Medicine, Miami, FL.
Int J Sports Phys Ther. 2019 Apr;14(2):296-307.
Impairments in postural stability have been identified following sports-related concussion. CaneSense™ is a recently developed mobile lower limb motion capture system and mobile application for movement assessment which provides an objective measure of postural stability. One of the components within CaneSense™ is the Post-Concussive Excursion Index (PCEI), a measure of postural stability expressed as a percentage of symmetry between lower limbs.
The purpose of this case series is to examine pre- and post-concussion differences using two separate measures, CaneSense™, and a known test, the Balance Error Scoring System (BESS), in Division I collegiate football players.
A convenience sample of eight football players diagnosed with a concussion, were the subjects in this case series. All subjects underwent baseline testing prior to the start of pre-season camp consisting of the single limb stance (SLS) test with CaneSense™ and the BESS test. Twenty-four to 72 hours following their concussion, SLS with CaneSense™ test and the BESS test, were administered. Segmental excursions for the thigh and shank segments for each lower limb were combined into the Post-Concussion Excursion Profile (PCEP), which represents each segment's maximum excursion in the medial-lateral and anterior-posterior direction. The PCEI is a single metric generated to quantify differences within subjects by comparing the PCEP value between lower limbs during SLS where 100% suggests absolute symmetry.
The PCEI value decreased significantly post-concussion (41.43 ± 15.53% vs. 87.41 ± 6.05%, p < 0.001) demonstrating a 52.6% decrease in inter-limb symmetry when compared to baseline values. There was an unanticipated 36.36% improvement in composite BESS performance post-concussion (10.5 ± 4.87 errors vs. 16.5 ± 8.49 errors, p = 0.10).
Differences in inter-limb postural stability were found in subjects post-concussion. By assessing postural stability in both lower limbs individually, using the PCEI, impairments were detected that otherwise would have likely gone undiagnosed using the BESS test alone.
Therapy, Level 4.
与运动相关的脑震荡后已发现姿势稳定性受损。CaneSense™是一种最近开发的用于运动评估的下肢移动动作捕捉系统和移动应用程序，可提供姿势稳定性的客观测量。CaneSense™中的一个组件是脑震荡后偏移指数（PCEI），它是一种姿势稳定性测量指标，以双下肢之间的对称百分比表示。
本病例系列的目的是使用两种独立的测量方法，即CaneSense™和一种已知测试平衡误差评分系统（BESS），来检查一级大学橄榄球运动员脑震荡前后的差异。
本病例系列的受试者为八名被诊断为脑震荡的橄榄球运动员的便利样本。所有受试者在季前训练营开始前接受了基线测试，包括使用CaneSense™进行的单腿站立（SLS）测试和BESS测试。在他们脑震荡后的24至72小时，进行了使用CaneSense™的SLS测试和BESS测试。将每个下肢大腿和小腿节段的节段偏移量合并为脑震荡后偏移剖面图（PCEP），它代表每个节段在内侧-外侧和前后方向上的最大偏移量。PCEI是通过比较SLS期间双下肢之间的PCEP值而生成的一个单一指标，用于量化受试者内部的差异，其中100%表示绝对对称。
脑震荡后PCEI值显著下降（41.43±15.53%对87.41±6.05%，p<0.001），与基线值相比，双下肢间对称性下降了52.6%。脑震荡后综合BESS表现意外提高了36.36%（10.5±4.87个错误对16.5±8.49个错误，p = 0.10）。
在脑震荡后的受试者中发现了双下肢姿势稳定性的差异。通过使用PCEI分别评估双下肢的姿势稳定性，检测到了损伤，否则仅使用BESS测试可能无法诊断出这些损伤。
治疗，4级。
