A Systematic Review of Center of Mass as a Measure of Dynamic Postural Control Following Concussion

BACKGROUND: The incidence of sports-related concussion in the US is between 1.6-3.8 million annually. Identification of ongoing impairment post-concussion continues to be challenging, as research indicates many patients are cleared for return to activity while still suffering subclinical impairment of function. Purpose: To identify and review the current literature on the use of center of mass (COM) during gait as a potential indicator variable after concussive injury. Study Design: Systematic Review METHODS: A Pubmed search was undertaken utilizing search terms involving gait performance and concussion. Study inclusion criteria included: (1) COM used as a variable in data analysis, (2) study population included individuals diagnosed with concussion, (3) postural control was evaluated throughout the recovery process. Articles were excluded if they were systematic reviews, unedited manuscripts, meta-analyses, or were more than 15 years old. RESULTS: Search of the PubMed database identified six articles which matched the determined criteria. The average STROBE score was 26.5/34 (range from 23-30). The areas that had the poorest scoring were bias, study size, statistical methods, participants, descriptive data, and main results. Results of the review indicate that COM displacement was higher in concussion groups with a sufficiently taxing task, such as a dual task paradigm. CONCLUSION: Center of mass measures during gait may be an indicator of ongoing concussive injury involvement after clinical indications have subsided. LEVEL OF EVIDENCE: 2a