The Toronto Concussion Study: Reference Data for Balance and Gait Measures in Community-Dwelling Adults with Concussion.

OBJECTIVE: Concussion can cause deficits in balance and gait. Much of what is known about how concussion affects balance and gait has been derived from studies involving youth, high school, and university-aged athletes. However, investigation into the effects of concussion on balance and gait in community-dwelling young, middle, and older age adults is limited. This study aimed to present descriptive reference values for common balance and gait measures in community-dwelling adults between the ages of 20 and 69 years with concussion.

METHODS: In this observational study, 318 participants were enrolled from a concussion care clinic at a rehabilitation hospital in an urban center and were assessed within 7 days of injury. Balance measures included the Balance Error Scoring System (BESS), modified BESS (mBESS), and center-of-pressure root mean square (COP RMS) during quiet standing. Gait measures included velocity (absolute and height adjusted), cadence, and step length during self-paced gait. Data were binned by decade-long age range.

RESULTS: Mean (SD) per-decade scores for the BESS ranged from 14.8 (5.1) to 21.8 (5.6) errors and 4.0 (3.0) to 9.4 (4.6) errors for the mBESS. Mean values for COP RMS in the anteroposterior direction ranged from 0.42 (0.18) to 0.52 (0.26) with the eyes open and from 0.49 (0.19) to 0.62 (0.39) with the eyes closed. Mean absolute gait velocity ranged from 98.5 (9.1) to 119.3 (21.3) cm/s. The range of step length values was 58.2 (6.8) to 66.3 (7.3) cm and cadence ranged from 102.1 (9.8) to 108.6 (10.8) steps/min across age groups.

CONCLUSION: These data provide insight into the impact of concussion on balance and mobility in community-dwelling adults across the lifespan.