{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T02:09:18Z","timestamp":1790215758838,"version":"4.1.0"},"reference-count":33,"publisher":"Human Kinetics","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,5,1]]},"abstract":"<jats:p><jats:italic><jats:bold>Objective<\/jats:bold>:<\/jats:italic> To determine the relationship between postural sway performance during commonly utilized postural control assessments following a concussion, including the modified Balance Error Scoring System (mBESS), concussion balance test (COBALT), and sensory organization test (SOT) in healthy young adults. <jats:italic><jats:bold>Approach<\/jats:bold>:<\/jats:italic> Twenty participants completed all balance testing. The mBESS conditions included double limb stance, single limb stance, and tandem stance. The COBALT was comprised of yaw plane head shake (HS) and vestibular ocular reflex cancellation conditions performed on firm and foam surfaces. Subjects performed 6 conditions of the SOT (C1\u2013C6), which systematically perturbed sensory inputs. Postural sway performance was measured using a single force plate and quantified as a sway score for the mBESS and COBALT, and an equilibrium score for the SOT. Spearman rank correlations were used to examine the relationship between postural sway performance for each test. <jats:italic><jats:bold>Main Results<\/jats:bold>:<\/jats:italic> There was a moderate positive correlation between mBESS-tandem stance and the HS on foam COBALT condition (<jats:italic>r<\/jats:italic>\u2009=\u2009.643, <jats:italic>P<\/jats:italic>\u2009=\u2009.002). There was a moderate negative correlation between mBESS-double limb stance and SOT-C6 (<jats:italic>r<\/jats:italic>\u2009=\u2009\u2212.512, <jats:italic>P<\/jats:italic>\u2009=\u2009.021), and between mBESS-single limb stance and SOT-C6 (<jats:italic>r<\/jats:italic>\u2009=\u2009\u2212.523, <jats:italic>P<\/jats:italic>\u2009=\u2009.018). The COBALT and SOT demonstrated numerous moderate to good negative correlations (<jats:italic>r<\/jats:italic>\u2009=\u2009\u2212.448 to \u2212.708, <jats:italic>P<\/jats:italic>\u2009\u2264\u2009.05), including a good negative correlation between HS on foam and SOT-C1 (<jats:italic>r<\/jats:italic>\u2009=\u2009\u2212.725, <jats:italic>P<\/jats:italic>\u2009=\u2009.0003). <jats:italic><jats:bold>Significance<\/jats:bold>:<\/jats:italic> Performance on the mBESS had minimal relationship to performance on the COBALT and SOT, suggesting that the clinical standard may not challenge sensory integration at the same capacity as other tests. All COBALT conditions had fair to good associations to at least 2 SOT conditions, suggesting both assessments are representative of sensory integration. Further investigation of the current clinical approach is warranted as the COBALT may be a clinically feasible test of sensory integration.<\/jats:p>","DOI":"10.1123\/jsr.2021-0291","type":"journal-article","created":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T10:03:06Z","timestamp":1644314586000},"page":"452-456","source":"Crossref","is-referenced-by-count":2,"title":["The Relationship Between Measures of Postural Control in Concussion Assessment"],"prefix":"10.1123","volume":"31","author":[{"given":"Courtney","family":"DeFeo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Heebner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie","family":"Baker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Hoch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Morelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"100","reference":[{"issue":"1","key":"r1","series-title":"Pediatrics","first-page":"e20154635","article-title":"Sports- and recreation-related concussions in US youth","volume":"138","author":"Bryan MA","year":"2016","unstructured":"Bryan MA, Rowhani-Rahbar A, Comstock RD, Rivara F. Sports- and recreation-related concussions in US youth. Pediatrics. 2016;138(1):e20154635. doi:10.1542\/peds.2015-463527325635"},{"issue":"5","key":"r2","series-title":"J Pediatr","first-page":"1221","article-title":"Vestibular deficits following youth concussion","volume":"166","author":"Corwin DJ","year":"2015","unstructured":"Corwin DJ, Wiebe DJ, Zonfrillo MR, et\u00a0al. Vestibular deficits following youth concussion. J Pediatr. 2015;166(5):1221\u20131225. PubMed ID: 25748568 doi:10.1016\/j.jpeds.2015.01.03925748568"},{"issue":"10","key":"r3","series-title":"Am J Sports Med","first-page":"2375","article-title":"A revised factor structure for the post-concussion symptom scale: baseline and postconcussion factors","volume":"40","author":"Kontos AP","year":"2012","unstructured":"Kontos AP, Elbin RJ, Schatz P, et\u00a0al. A revised factor structure for the post-concussion symptom scale: baseline and postconcussion factors. Am J Sports Med. 2012;40(10):2375\u20132384. PubMed ID: 22904209 doi:10.1177\/036354651245540022904209"},{"issue":"9","key":"r4","series-title":"Am J Phys Med Rehab","first-page":"653","article-title":"Two-year prospective study of relative risk of a second cerebral concussion","volume":"82","author":"Zemper ED","year":"2003","unstructured":"Zemper ED. Two-year prospective study of relative risk of a second cerebral concussion. Am J Phys Med Rehab. 2003;82(9):653\u2013659."},{"issue":"12","key":"r5","series-title":"Med Sci Sports Exerc","first-page":"2487","article-title":"Acute lower extremity injury rates increase after concussion in college athletes","volume":"47","author":"Lynall RC","year":"2015","unstructured":"Lynall RC, Mauntel TC, Padua DA, Mihalik JP. Acute lower extremity injury rates increase after concussion in college athletes. Med Sci Sports Exerc. 2015;47(12):2487\u20132492. PubMed ID: 26057941 doi:10.1249\/MSS.000000000000071626057941"},{"key":"r6","series-title":"Gait Posture","first-page":"284","article-title":"Dual-task gait differences in female and male adolescents following sport-related concussion","volume":"54","author":"Howell DR","year":"2017","unstructured":"Howell DR, Stracciolini A, Geminiani E, Meehan WP. Dual-task gait differences in female and male adolescents following sport-related concussion. Gait Posture. 2017;54:284\u2013289. PubMed ID: 28384609 doi:10.1016\/j.gaitpost.2017.03.03428384609"},{"issue":"2","key":"r7","series-title":"J Orthop Sports Phys Ther","first-page":"87","article-title":"Dual-task assessment protocols in concussion assessment: a systematic literature review","volume":"48","author":"Kleiner M","year":"2018","unstructured":"Kleiner M, Wong L, Dube A, Wnuk K, Hunter SW, Graham LJ. Dual-task assessment protocols in concussion assessment: a systematic literature review. J Orthop Sports Phys Ther. 2018;48(2):87\u2013103. PubMed ID: 29113571 doi:10.2519\/jospt.2018.743229113571"},{"issue":"suppl 2","key":"r8","series-title":"Age Ageing","first-page":"ii7","article-title":"Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls?","volume":"35","author":"Horak FB","year":"2006","unstructured":"Horak FB. Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? Age Ageing. 2006;35(suppl 2):ii7\u2013ii11. doi:10.1093\/ageing\/afl07716926210"},{"key":"r9","series-title":"Principles of neural science","author":"Kandel ER","year":"2000","unstructured":"Kandel ER, Schwartz JH, Jessell TM, et\u00a0al. Principles of neural science. Vol 4. New York, NY: McGraw-Hill; 2000."},{"issue":"4","key":"r10","series-title":"J Sport Health Sci","first-page":"227","article-title":"Current concepts in sport concussion management: a multifaceted approach","volume":"2","author":"Littleton A","year":"2013","unstructured":"Littleton A, Guskiewicz K. Current concepts in sport concussion management: a multifaceted approach. J Sport Health Sci. 2013;2(4):227\u2013235. doi:10.1016\/j.jshs.2013.04.003"},{"issue":"11","key":"r11","series-title":"Br J Sports Med","first-page":"895","article-title":"The sport concussion assessment tool 5th edition (SCAT5): background and rationale","volume":"51","author":"Echemendia RJ","year":"2017","unstructured":"Echemendia RJ, Meeuwisse W, McCrory P, et\u00a0al. The sport concussion assessment tool 5th edition (SCAT5): background and rationale. Br J Sports Med. 2017;51(11):895\u2013901. PubMed ID: 28446453 doi:10.1136\/bjsports-2016-097466"},{"issue":"6","key":"r12","series-title":"Clin J Sport Med","first-page":"471","article-title":"The reliability of the modified balance error scoring system","volume":"19","author":"Hunt TN","year":"2009","unstructured":"Hunt TN, Ferrara MS, Bornstein RA, Baumgartner TA. The reliability of the modified balance error scoring system. Clin J Sport Med. 2009;19(6):471\u2013475. PubMed ID: 19898074 doi:10.1097\/JSM.0b013e3181c12c7b19898074"},{"issue":"5","key":"r13","series-title":"Brain Injury","first-page":"596","article-title":"Normative data for the modified balance error scoring system in adults","volume":"27","author":"Iverson GL","year":"2013","unstructured":"Iverson GL, Koehle MS. Normative data for the modified balance error scoring system in adults. Brain Injury. 2013;27(5):596\u2013599. PubMed ID: 23473405 doi:10.3109\/02699052.2013.77223723473405"},{"issue":"5","key":"r14","series-title":"J Athl Train","first-page":"497","article-title":"Generalizability theory analysis of balance error scoring system reliability in healthy young adults","volume":"44","author":"Broglio SP","year":"2009","unstructured":"Broglio SP, Zhu W, Sopiarz K, Park Y. Generalizability theory analysis of balance error scoring system reliability in healthy young adults. J Athl Train. 2009;44(5):497\u2013502. PubMed ID: 19771288 doi:10.4085\/1062-6050-44.5.49719771288"},{"issue":"1","key":"r15","series-title":"J Athl Train","first-page":"51","article-title":"Repeat administration elicits a practice effect with the balance error scoring system but not with the standardized assessment of concussion in high school athletes","volume":"38","author":"Valovich TC","year":"2003","unstructured":"Valovich TC, Perrin DH, Gansneder BM. Repeat administration elicits a practice effect with the balance error scoring system but not with the standardized assessment of concussion in high school athletes. J Athl Train. 2003;38(1):51. PubMed ID: 12937472"},{"issue":"2","key":"r16","series-title":"J Athl Train","first-page":"156","article-title":"Performance on the balance error scoring system decreases after fatigue","volume":"39","author":"Wilkins JC","year":"2004","unstructured":"Wilkins JC, McLeod TCV, Perrin DH, Gansneder BM. Performance on the balance error scoring system decreases after fatigue. J Athl Train. 2004;39(2):156. PubMed ID: 1517386715173867"},{"issue":"2","key":"r17","series-title":"Clin J Sport Med","first-page":"174","article-title":"Sensitivity and specificity of the modified balance error scoring system in concussed collegiate student athletes","volume":"28","author":"Buckley TA","year":"2018","unstructured":"Buckley TA, Munkasy BA, Clouse BP. Sensitivity and specificity of the modified balance error scoring system in concussed collegiate student athletes. Clin J Sport Med. 2018;28(2):174\u2013176. PubMed ID: 28454123 doi:10.1097\/JSM.000000000000042628454123"},{"issue":"1","key":"r18","series-title":"Clin Sports Med","first-page":"89","article-title":"Balance assessment in the management of sport-related concussion","volume":"30","author":"Guskiewicz KM","year":"2011","unstructured":"Guskiewicz KM. Balance assessment in the management of sport-related concussion. Clin Sports Med. 2011;30(1):89\u2013102. PubMed ID: 21074084 doi:10.1016\/j.csm.2010.09.00421074084"},{"issue":"3","key":"r19","series-title":"J Neurol Phys Ther","first-page":"149","article-title":"Comparison of uninjured and concussed adolescent athletes on the concussion balance test (COBALT)","volume":"42","author":"Massingale S","year":"2018","unstructured":"Massingale S, Alexander A, Erickson S, et\u00a0al. Comparison of uninjured and concussed adolescent athletes on the concussion balance test (COBALT). J Neurol Phys Ther. 2018;42(3):149\u2013154. PubMed ID: 29864102 doi:10.1097\/NPT.000000000000022529864102"},{"issue":"5","key":"r20","series-title":"J Neurophysiol","first-page":"2733","article-title":"Stimulus-dependent changes in the vestibular contribution to human postural control","volume":"95","author":"Cenciarini M","year":"2006","unstructured":"Cenciarini M, Peterka R. Stimulus-dependent changes in the vestibular contribution to human postural control. J Neurophysiol. 2006;95(5):2733\u20132750. PubMed ID: 16467429 doi:10.1152\/jn.00856.200416467429"},{"issue":"3","key":"r21","series-title":"J Athl Train","first-page":"263","article-title":"Postural stability and neuropsychological deficits after concussion in collegiate athletes","volume":"36","author":"Guskiewicz KM","year":"2001","unstructured":"Guskiewicz KM, Ross SE, Marshall SW. Postural stability and neuropsychological deficits after concussion in collegiate athletes. J Athl Train. 2001;36(3):263. PubMed ID: 1293749512937495"},{"issue":"2","key":"r22","series-title":"Exp Brain Res","first-page":"219","article-title":"Attentional focus influences postural control and reaction time performances only during challenging dual-task conditions in healthy young adults","volume":"231","author":"Remaud A","year":"2013","unstructured":"Remaud A, Boyas S, Lajoie Y, Bilodeau M. Attentional focus influences postural control and reaction time performances only during challenging dual-task conditions in healthy young adults. Exp Brain Res. 2013;231(2):219\u2013229. doi:10.1007\/s00221-013-3684-023995564"},{"issue":"2","key":"r23","series-title":"J Athl Train","first-page":"170","article-title":"Balance performance with a cognitive task: a continuation of the dual-task testing paradigm","volume":"46","author":"Resch J","year":"2011","unstructured":"Resch J, May B, Tomporowski P, Ferrara M. Balance performance with a cognitive task: a continuation of the dual-task testing paradigm. J Athl Train. 2011;46(2):170\u2013175. PubMed ID: 21391802 doi:10.4085\/1062-6050-46.2.17021391802"},{"issue":"1","key":"r24","series-title":"J Athl Train","first-page":"19","article-title":"Effects of mild head injury on postural stability as measured through clinical balance testing","volume":"35","author":"Riemann BL","year":"2000","unstructured":"Riemann BL, Guskiewicz KM. Effects of mild head injury on postural stability as measured through clinical balance testing. J Athl Train. 2000;35(1):19. PubMed ID: 1655860316558603"},{"issue":"2","key":"r25","series-title":"Hum Mov Sci","first-page":"268","article-title":"Postural control in otolith disorders","volume":"24","author":"Basta D","year":"2005","unstructured":"Basta D, Todt I, Scherer H, Clarke A, Ernst A. Postural control in otolith disorders. Hum Mov Sci. 2005;24(2):268\u2013279. PubMed ID: 15953652 doi:10.1016\/j.humov.2005.04.00215953652"},{"issue":"3","key":"r26","series-title":"Athl Train Sports Health Care","article-title":"Test\u2013retest reliability and methodological considerations of the sensory organization test in healthy young adults","volume":"13","author":"Quintana C","year":"2020","unstructured":"Quintana C, Heebner NR, Picha K, Andrews M, Abt J, Hoch MC. Test\u2013retest reliability and methodological considerations of the sensory organization test in healthy young adults. Athl Train Sports Health Care. 2020;13(3):103\u2013110."},{"issue":"1","key":"r27","series-title":"Nutr Clin Pract","first-page":"76","article-title":"Biostatistics primer: part 2","volume":"23","author":"Overholser BR","year":"2008","unstructured":"Overholser BR, Sowinski KM. Biostatistics primer: part 2. Nutr Clin Pract. 2008;23(1):76\u201384. PubMed ID: 18203967 doi:10.1177\/01154265080230017618203967"},{"issue":"3","key":"r28","series-title":"Malawi Med J","first-page":"69","article-title":"Statistics corner: a guide to appropriate use of correlation in medical research","volume":"24","author":"Mukaka M","year":"2012","unstructured":"Mukaka M. Statistics corner: a guide to appropriate use of correlation in medical research. Malawi Med J. 2012;24(3):69\u201371. PubMed ID: 2363827823638278"},{"key":"r29","series-title":"Front Neurol","first-page":"444","article-title":"Postural control in bilateral vestibular failure: its relation to visual, proprioceptive, vestibular, and cognitive input","volume":"8","author":"Sprenger A","year":"2017","unstructured":"Sprenger A, Wojak JF, Jandl NM, Helmchen C. Postural control in bilateral vestibular failure: its relation to visual, proprioceptive, vestibular, and cognitive input. Front Neurol. 2017;8:444.28919878"},{"issue":"3","key":"r30","series-title":"J Neurophysiol","first-page":"1097","article-title":"Sensorimotor integration in human postural control","volume":"88","author":"Peterka RJ","year":"2002","unstructured":"Peterka RJ. Sensorimotor integration in human postural control. J Neurophysiol. 2002;88(3):1097\u20131118. PubMed ID: 12205132 doi:10.1152\/jn.2002.88.3.109712205132"},{"issue":"9","key":"r31","series-title":"Ann Biomed Eng","first-page":"2135","article-title":"Sensor-based balance measures outperform modified balance error scoring system in identifying acute concussion","volume":"45","author":"King LA","year":"2017","unstructured":"King LA, Mancini M, Fino PC, et\u00a0al. Sensor-based balance measures outperform modified balance error scoring system in identifying acute concussion. Ann Biomed Eng. 2017;45(9):2135\u20132145. PubMed ID: 28540448 doi:10.1007\/s10439-017-1856-y28540448"},{"key":"r32","series-title":"Clin Biomech","first-page":"79","article-title":"Quantification of postural control deficits in patients with recent concussion: an inertial-sensor based approach","volume":"42","author":"Doherty C","year":"2017","unstructured":"Doherty C, Zhao L, Ryan J, Komaba Y, Inomata A, Caulfield B. Quantification of postural control deficits in patients with recent concussion: an inertial-sensor based approach. Clin Biomech. 2017;42:79\u201384. doi:10.1016\/j.clinbiomech.2017.01.007"},{"issue":"11","key":"r33","series-title":"Clin Neurophysiol","first-page":"2424","article-title":"The clinical utility of posturography","volume":"119","author":"Visser JE","year":"2008","unstructured":"Visser JE, Carpenter MG, van der Kooij H, Bloem BR. The clinical utility of posturography. Clin Neurophysiol. 2008;119(11):2424\u20132436. PubMed ID: 18789756 doi:10.1016\/j.clinph.2008.07.22018789756"}],"container-title":["Journal of Sport Rehabilitation"],"original-title":[],"link":[{"URL":"https:\/\/journals.humankinetics.com\/view\/journals\/jsr\/31\/4\/article-p452.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.humankinetics.com\/downloadpdf\/journals\/jsr\/31\/4\/article-p452.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/journals.humankinetics.com\/downloadpdf\/journals\/jsr\/31\/4\/article-p452.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T23:30:24Z","timestamp":1756337424000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.humankinetics.com\/view\/journals\/jsr\/31\/4\/article-p452.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,1]]},"references-count":33,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.1123\/jsr.2021-0291","relation":{},"ISSN":["1056-6716","1543-3072"],"issn-type":[{"value":"1056-6716","type":"print"},{"value":"1543-3072","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,1]]}}}