Nicholas G. Murray, Anthony P. Salvatore, Joe Tomaka, Rebecca J. Reed-Jones

Murray et al., J Clin Transl Res, 2016; 2(1): 38-44
Published online: 15 April, 2016


Background: Approximately 30% of individuals with a sport-related concussion present with postural instability. Multiple clinical balance tests exist to diagnose postural instability; yet little is known about the potential relationship between these type of postural assessments and cognition post-concussion. Aim: The purpose of the current study was to assess the relationship between the Romberg test, the Wii Fit basic balance test (WBBT), and the composite scores on the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) test in a sample of athletes with concussions.
Methods: 55 post-concussed athletes (40 male) completed the Romberg Test (RT) (−/+), the WBBT, and ImPACT test. Wii Fit basic balance test performance was operationalized as the number of successfully completed trials (of 5 trials of increasing difficulty) within 30 seconds. Pearson’s and point-biserial correlations examined univariate associations among the variables.
Results: The RT and WBBT were not significantly related (r = −0.029, p = 0.832). The RT weakly correlated with ImPACT impairment scores (r= 0.26, p= 0.041), whereas WBBT the number of trials did not (r = − 0.20, p = 0.155). Romberg Test scores were significantly correlated with ImPACT Visual Processing Speed Score (r = 0.27, p = 0.036) and Reaction Time score (r = 0.34, p = 0.006). In contrast, WBBT trials were significantly correlated with the ImPACT Visual Memory Score (r = − 0.41, p = 0.003). 
Conclusions: These results suggest that the WBBT and RT assess unique aspects of postural control. The RT may relate directly to single sensory cognitive and motor processing, while the WBBT may relate to multi-sensory visually driven cognitive and motor processing.
Relevance for patients: Clinical balance tests could point to different cognitive impairments post-concussion. 


Author affiliation

1 School of Health and Kinesiology, Georgia Southern University, Statesboro, Georgia, United States
2 Department of Rehabilitation Sciences, UTEP Concussion Management Clinic, College of Health Sciences, University of Texas at El Paso, El Paso, Texas, United States
3 College of Health and Social Services, Department of Public Health Sciences, New Mexico State University, Las Cruces, New Mexico, United States
4 Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Canada

*Corresponding author
Nicholas G. Murray
Tel: +1 912 478 0203

Handling editor:
Rowan van Golen
Department of Experimental Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands


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