Purpose: The goal of this project was to explore the role of the vestibular system in balance, how balance relates to concussion, and current balance assessments for pre- and post-concussion. This project synthesizes the current evidence-based research to an athletic population in order to evaluate the implications on physical therapy evaluation and management of athletes who sustained a concussion.
Results: Research suggests that balance deficits may occur secondary to impairment of brain centers responsible for central integration of vestibular, visual, and somatosensory stimuli, damage to peripheral receptors causing erroneous senses of motion, or concentration and attention impairments that may exist post-concussion. While the cause of postural instability and balance disturbance post-concussion may not be certain, it is certain that these deficits do exist, and like other concussion signs and symptoms, are transient in nature.
Conclusion: Further research regarding the relationship between balance and concussions is necessary to ensure proper screening and preventative care. The creation of a comprehensive balance assessment to be included in a standardized concussion management protocol is warranted. A newly evolving paradigm in research is a dual task assessment that encompasses cognitive and motor tasks simultaneously. Dual-task is especially relevant when studying athletes because sports require athletes to process cognitive and sensory stimuli simultaneously. A dual-task paradigm has the ability to replicate an athlete’s performance in a “game-like situation” to evaluate multiple systems concurrently. Discovering pre-season or post-concussive balance impairments provides physical therapists with a unique opportunity to perform vestibular rehabilitation with athletes.