In People with Subacute Mild Traumatic Brain Injury, earlier Physical Therapy Improved Symptoms at a Faster Rate than Later Physical Therapy: Randomized Controlled Trial.

Importance: There is unclear evidence on when to initiate physical therapy after mild traumatic brain injury (mTBI) in non-athlete, adult population.

Objective: The objective of this study was to investigate physical therapy timing after mTBI through changes in patient-reported and clinically-assessed tools and objective and mechanism measurements of sensorimotor balance control.

Design: This study was an investigator-blinded randomized control trial (NCT03479541).

Utility of the Vestibular/Ocular Motor Screening in Military Medicine: A Systematic Review.

Introduction: The Vestibular/Ocular Motor Screening (VOMS) was created as a brief clinical screening tool for identifying vestibular and ocular motor symptoms and impairments post-concussion. It was found to have predictive validity in correctly identifying concussed athletes from healthy controls. In 2018, the Military Acute Concussion Evaluation 2 (MACE2) replaced the original Military Acute Concussion Evaluation (MACE); the most prominent change between the MACE and MACE2 was the addition of the VOMS.

Integration of auditory and visual cues in spatial navigation under normal and impaired viewing conditions.

Auditory landmarks can contribute to spatial updating during navigation with vision. Whereas large inter-individual differences have been identified in how navigators combine auditory and visual landmarks, it is still unclear under what circumstances audition is used. Further, whether or not individuals optimally combine auditory cues with visual cues to decrease the amount of perceptual uncertainty, or variability, has not been well-documented.

Confidence to Return to Play After Concussion.

Context: The sequelae of concussion may have psychological consequences that affect an athlete's ability to return to play (RTP). However, confidence of RTP readiness is rarely monitored after a concussion.

Design: This study examined the acute and longitudinal implications of concussion on an athlete's confidence to RTP, the relationship between self-reported symptoms and athlete confidence to RTP, and interactions between concussion symptoms, sex, sport type (contact vs noncontact), and confidence to RTP.

The Effect of Intranasal Plus Transcranial Photobiomodulation on Neuromuscular Control in Individuals with Repetitive Head Acceleration Events.

This proof-of-concept study was to investigate the relationship between photobiomodulation (PBM) and neuromuscular control. The effects of concussion and repetitive head acceleration events (RHAEs) are associated with decreased motor control and balance. Simultaneous intranasal and transcranial PBM (itPBM) is emerging as a possible treatment for cognitive and psychological sequelae of brain injury with evidence of remote effects on other body systems.

Sensory integration and segmental control of posture during pregnancy.

Background: Approximately 25% of pregnant people fall, yet the underlying mechanisms of this increased fall-risk remain unclear. Prior studies examining pregnancy and balance have utilized center of pressure analyses and reported mixed results. The purpose of this study was to examine sensory and segmental contributions to postural control throughout pregnancy using accelerometer-based measures of sway.

The Impact of Design Factors on User Behavior in a Virtual Hospital Room to Explore Fall Prevention Strategies.

Objectives: Falls in hospitals pose a significant safety risk, leading to injuries, prolonged hospitalization, and lasting complications. This study explores the potential of augmented reality (AR) technology in healthcare facility design to mitigate fall risk.

Background: Few studies have investigated the impact of hospital room layouts on falls due to the high cost of building physical prototypes.

Acute and Longitudinal Effects of Sport-related Concussion on Reactive Balance.

Postural instability is a common observation after concussions, with balance assessments playing a crucial role in clinical evaluations. Widely used post-concussion balance tests focus primarily on static and dynamic balance, excluding the critical aspect of reactive balance. This study investigated the acute and longitudinal effects of concussion on reactive balance in collegiate athletes.

Effects of older age on visual and self-motion sensory cue integration in navigation.

Older adults demonstrate impairments in navigation that cannot be explained by general cognitive and motor declines. Previous work has shown that older adults may combine sensory cues during navigation differently than younger adults, though this work has largely been done in dark environments where sensory integration may differ from full-cue environments. Here, we test whether aging adults optimally combine cues from two sensory systems critical for navigation: vision (landmarks) and body-based self-motion cues.

Walking (and talking) the plank: dual-task performance costs in a virtual balance-threatening environment.

We evaluated the effects of engaging in extemporaneous speech in healthy young adults while they walked in a virtual environment meant to elicit low or high levels of mobility-related anxiety. We expected that mobility-related anxiety imposed by a simulated balance threat (i.e.

Consequences of changing planned foot placement on balance control and forward progress.

While walking humans generally plan foot placement two steps in advance. However, it is often necessary to rapidly alter foot placement position just before stepping due to the appearance of a new obstacle. While humans are quite capable of rapidly altering foot placement position, such changes can have major effects on centre of mass dynamics.

Age and beta amyloid deposition impact gait speed, stride length, and gait smoothness while transitioning from an even to an uneven walking surface in older adults.

Background: Capturing a measure of movement quality during a complex walking task may indicate the earliest signs of detrimental changes to the brain due to beta amyloid (Aβ) deposition and be a potential differentiator of older adults at elevated and low risk of developing Alzheimer's disease. This study aimed to determine: 1) age-related differences in gait speed, stride length, and gait smoothness while transitioning from an even to an uneven walking surface, by comparing young adults (YA) and older adults (OA), and 2) if gait speed, stride length, and gait smoothness in OA while transitioning from an even to an uneven walking surface is influenced by the amount of Aβ deposition present in an OA's brain.

Methods: Participants included 56 OA (>70 years of age) and 29 YA (25-35 years of age).

Instrumented Static and Reactive Balance in Collegiate Athletes: Normative Values and Minimal Detectable Change.

Context: Wearable sensors are increasingly popular in concussion research because of their objective quantification of subtle balance deficits. However, normative data and minimal detectable change (MDC) values are necessary to serve as references for diagnostic use and tracking longitudinal recovery.

Objective: To identify normative and MDC values for instrumented static- and reactive-balance tests, an instrumented static mediolateral (ML) root mean square (RMS) sway standing balance assessment and the instrumented, modified push and release (I-mP&R), respectively.

Relation Between Cognitive Assessment and Clinical Physical Performance Measures After Mild Traumatic Brain Injury.

Objectives: To investigate the relation between cognitive and motor performance in individuals with mild traumatic brain injury (mTBI) and examine differences in both cognitive and motor performance between adults after mTBI and healthy controls.

Design: Multi-center, cross-sectional study.

Setting: Three institutional sites (Courage Kenny Research Center, Minneapolis, MN, Oregon Health & Science University, Portland, OR, and University of Utah, Salt Lake City, UT).

Reconsidering Vestibular/Ocular Motor Screening Cutoff Scores for Concussion.

Introduction: Vestibular/Ocular Motor Screening (VOMS) is often part of a comprehensive evaluation to identify acute mild traumatic brain injury. Most of the reports describe the use of the VOMS in adolescents/young adults and not in older adults or military service members. The purpose of this study was to describe VOMS findings in healthy civilians and active duty military service members up to the age of 50 years.

Quantifying Turning Tasks With Wearable Sensors: A Reliability Assessment.

Objective: The aim of this study was to establish the test-retest reliability of metrics obtained from wearable inertial sensors that reflect turning performance during tasks designed to imitate various turns in daily activity.

Methods: Seventy-one adults who were healthy completed 3 turning tasks: a 1-minute walk along a 6-m walkway, a modified Illinois Agility Test (mIAT), and a complex turning course (CTC). Peak axial turning and rotational velocity (yaw angular velocity) were extracted from wearable inertial sensors on the head, trunk, and lumbar spine.

Sensory functions and their relation to balance metrics: a secondary analysis of the LIMBIC-CENC multicenter cohort.

Introduction: Among patients with traumatic brain injury (TBI), balance problems often persist alongside hearing and vision impairments that lead to poorer outcomes of functional independence. As such, the ability to regain premorbid independent gait may be dictated by the level of sensory acuity or processing decrements that are shown following TBI assessment. This study explores the relationships between standardized sensory acuity and processing outcomes to postural balance and gait speed.

A Dynamical Systems Approach to Characterizing Brain-Body Interactions during Movement: Challenges, Interpretations, and Recommendations.

Brain-body interactions (BBIs) have been the focus of intense scrutiny since the inception of the scientific method, playing a foundational role in the earliest debates over the philosophy of science. Contemporary investigations of BBIs to elucidate the neural principles of motor control have benefited from advances in neuroimaging, device engineering, and signal processing. However, these studies generally suffer from two major limitations.

The effect of mobility-related anxiety on walking across the lifespan: a virtual reality simulation study.

Older adults who report a fear of falling are more likely to subsequently fall, yet, some gait anxiety-related alterations may protect balance. We examined the effect of age on walking in anxiety-inducing virtual reality (VR) settings. We predicted a high elevation-related postural threat would impair gait in older age, and differences in cognitive and physical function would relate to the observed effects.

The choice of reference frame alters interpretations of turning gait and stability.

Humans regularly follow curvilinear trajectories during everyday ambulation. However, globally-defined and locally-defined reference frames fall out of alignment during turning gait, which complicates spatiotemporal and biomechanical analyses. Thus, the choice of the locally-defined reference frame is an important methodological consideration.

Volitional Head Movement Deficits and Alterations in Gait Speed Following Mild Traumatic Brain Injury.

Objective: Unconstrained head motion is necessary to scan for visual cues during navigation, for minimizing threats, and to allow regulation of balance. Following mild traumatic brain injury (mTBI) people may experience alterations in head movement kinematics, which may be pronounced during gait tasks. Gait speed may also be impacted by the need to turn the head while walking in these individuals.

Reactive postural responses predict risk for acute musculoskeletal injury in collegiate athletes.

Unlabelled: Identifying risk factors for musculoskeletal injury is critical to maintain the health and safety of athletes. While current tests consider isolated assessments of function or subjective ratings, objective tests of reactive postural responses, especially when in cognitively demanding scenarios, may better identify risk of musculoskeletal injury than traditional tests alone.

Objectives: Examine if objective assessments of reactive postural responses, quantified using wearable inertial measurement units, are associated with the risk for acute lower extremity musculoskeletal injuries in collegiate athletes.