Affiliations: [a] Sports Medicine Center, Children’s Hospital Colorado, Aurora, CO, USA
| [b] Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA
| [c] Department of Physical Therapy, University of Delaware, Newark, DE, USA
| [d] Department of Physical Medicine and Rehabilitation, Children’s Hospital of Colorado, Aurora, CO, USA
| [e] Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO, USA
Correspondence:
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Corresponding author: David R. Howell, PhD, ATC. Sports Medicine Center, Children’s Hospital Colorado; Department of Orthopedics, University of Colorado School of Medicine. Address: 13123 E. 16th Avenue, B060 Aurora, CO 80045, USA. Tel.: +1 7207771502; E-mail: David.Howell@CUAnschutz.edu. ORCID: 0000-0002-2955-0191
Abstract: PURPOSE:To examine the effect of age on postural control outcomes among patients being seen during their initial post-concussion clinical visit. METHODS:Youth patients were seen≤14 days post-concussion, and completed a series of postural control evaluations: tandem gait, Romberg, and Balance Error Scoring System (BESS) tests. RESULTS:We included 109 children 8–12 years of age (24% female, evaluated median = 7 [interquartile range = 4–10] days post-injury) and 353 adolescents aged 13–18 years (36% female, evaluated median = 7 [4–10] days post-injury). There was a higher proportion of children who demonstrated abnormal tandem gait relative to adolescents (26% vs. 11%; p < 0.001). They also made more BESS errors in single (median = 5 [2–10] vs. 4 [2–6] errors) and tandem (median = 3 [1–6] vs. 2 [0–4]) firm stances. After covariate adjustment, children demonstrated worse tandem gait (adjusted odds ratio = 3.05, 95% CI = 1.68–5.53) and more firm surface BESS errors (double stance β=0.51, 95% CI = 0.22–0.80; single stance β= 1.18, 95% CI = 0.42–1.95; tandem stance β= 0.98, 95% CI = 0.28–1.68) than adolescents. CONCLUSIONS:Tandem gait and BESS performance following concussion differ in children compared to adolescents who present within 2 weeks of injury. Clinicians assessing and managing concussion should recognize age differences in postural control performance when assessing those with concussion.
