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J Athl Train. 2017 Mar;52(3):245-255. doi: 10.4085/1062-6050-52.1.13.

Evaluation of Nintendo Wii Balance Board as a Tool for Measuring Postural Stability After Sport-Related Concussion.

Author information

1
Departments of * Emergency Medicine.
2
Public Health Sciences, and.
3
Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.
4
School of Exercise Science, Australian Catholic University, Fitzroy, Victoria.
5
Neurology, Neurosurgery, and Physical Medicine and Rehabilitation, University of Rochester School of Medicine and Dentistry, NY.

Abstract

CONTEXT:

Recent changes to postconcussion guidelines indicate that postural-stability assessment may augment traditional neurocognitive testing when making return-to-participation decisions. The Balance Error Scoring System (BESS) has been proposed as 1 measure of balance assessment. A new, freely available software program to accompany the Nintendo Wii Balance Board (WBB) system has recently been developed but has not been tested in concussed patients.

OBJECTIVE:

To evaluate the feasibility of using the WBB to assess postural stability across 3 time points (baseline and postconcussion days 3 and 7) and to assess concurrent and convergent validity of the WBB with other traditional measures (BESS and Immediate Post-Concussion Assessment and Cognitive Test [ImPACT] battery) of assessing concussion recovery.

DESIGN:

Cohort study.

SETTING:

Athletic training room and collegiate sports arena.

PATIENTS OR OTHER PARTICIPANTS:

We collected preseason baseline data from 403 National Collegiate Athletic Association Division I and III student-athletes participating in contact sports and studied 19 participants (age = 19.2 ± 1.2 years, height = 177.7 ± 8.0 cm, mass = 75.3 ± 16.6 kg, time from baseline to day 3 postconcussion = 27.1 ± 36.6 weeks) who sustained concussions.

MAIN OUTCOME MEASURE(S):

We assessed balance using single-legged and double-legged stances for both the BESS and WBB, focusing on the double-legged, eyes-closed stance for the WBB, and used ImPACT to assess neurocognition at 3 time points. Descriptive statistics were used to characterize the sample. Mean differences and Spearman rank correlation coefficients were used to determine differences within and between metrics over the 3 time points. Individual-level changes over time were also assessed graphically.

RESULTS:

The WBB demonstrated mean changes between baseline and day 3 postconcussion and between days 3 and 7 postconcussion. It was correlated with the BESS and ImPACT for several measures and identified 2 cases of abnormal balance postconcussion that would not have been identified via the BESS.

CONCLUSIONS:

When accompanied by the appropriate analytic software, the WBB may be an alternative for assessing postural stability in concussed student-athletes and may provide additional information to that obtained via the BESS and ImPACT. However, verification among independent samples is required.

KEYWORDS:

athletes; balance; mild traumatic brain injury; neurocognitive testing; recovery; return-to-play guidelines

PMID:
28387551
PMCID:
PMC5384822
DOI:
10.4085/1062-6050-52.1.13
[Indexed for MEDLINE]
Free PMC Article

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