September 25, 2023

Gait Posture. 2023 Aug 28;106:42-46. doi: 10.1016/j.gaitpost.2023.08.012. Online ahead of print.


BACKGROUND: Concussions or musculoskeletal injuries may impair postural control, which is one diagnostic to help determine return-to-activity decisions. Postural control may be affected by diurnal rhythm.

RESEARCH QUESTION: Does time of day influence postural control as measured by two Neurocom Balance Master diagnostic protocols, the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB) and the Stability Evaluation Test (SET)?

METHODS: Following Institutional Review Board (IRB) approval, consented participants completed the SET and mCTSIB twice: between 0700 and 1000; and between 1600 and 1900. We randomized and balanced testing order. Familiarization trials were completed for the mCTSIB and SET. Assessments were completed in a controlled laboratory environment. We instructed participants to get a normal night’s sleep prior to testing and refrain from caffeine use and exhaustive exercise on the day of testing. Sixty-nine participants (48 female, 21 male: age = 21.42±2.56 years, height = 168.20±7.53 cm, mass = 72.05±16.60 kg) completed the study. Thirty-one of the participants were National Association of Intercollegiate Athletes (NAIA) student-athletes from the sports of baseball, soccer and softball. Average postural sway velocity was measured and compared by time of day for each of the balance conditions in the mCTSIB and SET protocols.

RESULTS: According to repeated measures ANOVA, there were no significant postural sway velocity main effects by time of day for any of the balance conditions. We found significant postural sway main effects by foam, stance and eyes. We also noted significant ANOVA between participants’ differences for athlete status, but not for sex.

SIGNIFICANCE: These results inform practitioners about the importance of controlling time-of-day between baseline and post-injury testing, which may allow for more flexible, accurate and reliable diagnosis and return-to-activity decisions. Athletes displayed better static postural control, possibly warranting different normative values for diagnostic comparison.

PMID:37651833 | DOI:10.1016/j.gaitpost.2023.08.012