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Recovery Trajectory of Postural Control Impairments Following a Concussion: A Case Study.

CONTEXT:: Altered postural control represents one of the most common motor consequences following a concussion and there is a paucity of data monitoring the recovery trajectory that identifies the persistent changes of postural control.

OBJECTIVE:: To determine whether the recovery trajectory of postural control was consistent across different measures of postural stability and whether increased postural challenge (i.e., sloped surface) revealed subtle postural impairments.

DESIGN:: A single subject case study.

SETTING:: Research laboratory.

PATIENTS OR OTHER PARTICIPANTS:: One concussed individual with a cohort of healthy controls (n=10) used for comparison.

MAIN OUTCOME MEASURES:: Center of pressure (CoP) variability (linear - standard deviation and non-linear - multiscale entropy) was used to index postural sway pre-injury and at periodic intervals following the concussion.

RESULTS:: The concussed individuals displayed reduced amounts of sway during the initial recovery phase that failed to returned to pre-injury levels but reached the level of healthy controls at one-month post injury. The multiscale entropy analysis revealed increased CoP irregularity throughout recovery that persisted up to one-month post injury.

CONCLUSIONS:: The findings identified subtle, persistent postural control impairments revealed through the nonlinear analysis of CoP and supports the notion that the consequences of a concussion (i.e., impaired postural control) need to be considered beyond the resolution of behavioral symptoms.

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