Dummar Max K, Crowell Michael S, Pitt Will, Yu Ai Mei, McHenry Paige, Benedict Timothy, Morris Jamie, Miller Erin M
Keller Army Community Hospital Division 1 Sports Physical Therapy Fellowship Baylor University.
Keller Army Community Hospital Division 1 Sports Physical Therapy Fellowship, Baylor University.
Int J Sports Phys Ther. 2024 Feb 1;19(2):166-175. doi: 10.26603/001c.92234. eCollection 2024.
Concussions are often accompanied by balance disturbances. Clinically accurate evaluation systems are often expensive, large, and inaccessible to most clinicians. The Sway Balance Mobile Application (SWAY) is an accessible method to quantify balance changes.
To determine the known groups and convergent validity of the SWAY to assess balance after a concussion.
Case-Control Study.
Twenty participants with acute concussion and twenty controls were recruited. At initial, one-week, and final return to activity (RTA) evaluations, all participants completed the Sports Concussion Assessment Tool (SCAT-5), and balance control measured by SWAY mBESS and NeuroCom Balance Master Sensory Organization Test (SOT). Mixed model ANOVAs were used to detect differences in SWAY mBESS and NeuroCom SOT scores with time (initial, one-week, final RTA) as the within-subjects factor and group (concussed, healthy) as the between-subjects factor. Spearman's Rho correlations explored the associations between NeuroCom SOT scores, SWAY scores, SCAT-5 symptom scores, and time in days to final RTA.
The sampled population was predominantly male and age (20 ± 1), and BMI differences were insignificant between groups. The SWAY did not detect differences between healthy and concussed participants and did not detect change over time [F(2,40) = .114, p = 0.89; F(2,40)= .276, p =0.60]. When assessing the relationship between the SWAY and the SOT, no correlation was found at any time point (r = -0.317 to -0.062, p > 0.05). Time to RTA demonstrated a moderate correlation with both SCAT-5 symptom severity score (r = .693, p < 0.01) and SCAT-5 total symptom score (r = .611, p < 0.01) at the one-week follow-up.
The SWAY mBESS does not appear to be a valid balance assessment for the concussed patient. The SWAY mBESS in patients with concussion failed to demonstrate convergent validity and did not demonstrate an ability to validate known groups. When assessing the time to final RTA, the one-week post-initial assessment SCAT-5 symptom severity and total scores may help determine the length of recovery in this population.
Level 3.
脑震荡常伴有平衡障碍。临床上准确的评估系统通常价格昂贵、体积庞大，大多数临床医生难以使用。摇摆平衡移动应用程序（SWAY）是一种可用于量化平衡变化的方法。
确定SWAY评估脑震荡后平衡的已知组效度和收敛效度。
病例对照研究。
招募了20名急性脑震荡参与者和20名对照者。在初始、一周和最终恢复活动（RTA）评估时，所有参与者均完成了运动脑震荡评估工具（SCAT-5），并通过SWAY mBESS和NeuroCom平衡大师感觉统合测试（SOT）测量平衡控制能力。采用混合模型方差分析来检测SWAY mBESS和NeuroCom SOT分数随时间（初始、一周、最终RTA）的差异，其中时间为受试者内因素，组（脑震荡组、健康组）为受试者间因素。Spearman等级相关分析探讨了NeuroCom SOT分数、SWAY分数、SCAT-5症状分数与至最终RTA天数之间的关联。
抽样人群以男性为主，年龄为（20±1）岁，两组间体重指数差异不显著。SWAY未检测到健康参与者和脑震荡参与者之间的差异，也未检测到随时间的变化[F(2,40)=0.114，p = 0.89；F(2,40)=0.276，p = 0.60]。在评估SWAY与SOT之间的关系时，在任何时间点均未发现相关性（r = -0.317至-0.062，p > 0.05）。在一周随访时，至RTA的时间与SCAT-5症状严重程度评分（r = 0.693，p < 0.01）和SCAT-5总症状评分（r = 0.611，p < 0.01）均呈中度相关。
SWAY mBESS似乎不是评估脑震荡患者平衡的有效方法。脑震荡患者的SWAY mBESS未能证明收敛效度，也未显示出验证已知组的能力。在评估至最终RTA的时间时，初始评估后一周的SCAT-5症状严重程度和总分可能有助于确定该人群的恢复时间。
3级。
