Can a Balance Test Predict Sport-Related Concussion Symptoms in Children?

Postural stability tests may be able to predict the length of concussion symptoms in children and adolescents, according to new research.

This conclusion comes after results of a new study demonstrated that abnormal performance on the Romberg test within 10 days after receiving a sports-related concussion diagnosis was independently associated with a longer duration of symptoms during recovery.


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To reach this conclusion, the researchers analyzed data on 351 participants—33% of whom were girls—who had visited the Children’s Hospital Colorado Sports Medicine Center between January 1, 2015, and August 31, 2017. The median age was 14.9 years, and the participants were evaluated at a median of 6 days days after concussion.

Participants were followed until they no longer experienced concussion symptoms, with the median duration of symptoms being 23 days.

To determine which variables could best predict the time from injury until symptom resolution, the researchers evaluated the participants’ preinjury factors; Health and Behavior Inventory scores; headache severity; and balance, vestibular, and oculomotor test performances in the 10 days after injury.

Several variables—including headache severity, headache frequency, confusion, forgetfulness, attention difficulties, trouble remembering, getting tired often, getting tired easily, dizziness, and abnormal performance on the Romberg test—were associated with a longer duration of symptoms.

An abnormal performance on the Romberg test was determined to be the only variable that was independently associated with a longer duration of symptoms.

“The results suggest that clinicians may consider implementing the Romberg test as a screen for potential prolonged recovery in child and adolescent athletes,” the researchers concluded. “As preinjury mental health conditions, prior concussions, and being a teenager or female seem to be the most consistent predictors of persistent concussion symptom risk, future studies should continue to develop prospective methods to better understand individual factors related to recovery time following concussion.”

—Colleen Murphy


Howell DR, Potter MNKirkwood MWWilson PEProvance AJ, Wilson JC. Clinical predictors of symptom resolution for children and adolescents with sport-related concussion [published online April 16, 2019]. J Neurosurg Pediatr.