Assessment of balance in people with mild traumatic brain injury using a balance systems model approach.
Kody R Campbell, Kathleen T Scanlan, Jennifer L Wilhelm and 5 others
PMID 36516644WHAT IT FOUND
People with subacute concussion scored lower on the Mini-BESTest than healthy controls, particularly in dynamic gait and reactive postural control.
However, total scores did not correlate with overall self-reported symptom severity, meaning patients may underreport functional deficits.
Key findings
01Participants with subacute mTBI had significantly lower Mini-BESTest total scores and lower scores in reactive postural control, dynamic gait, and sensory orientation compared to healthy controls, but no significant difference in anticipatory postural adjustment.
02There was no significant relationship between Mini-BESTest total scores and overall self-reported mTBI symptoms, though a weak correlation existed with the vestibular subscale.
03A large proportion of mTBI participants had specific deficits in dual-task walking, head turns, and backward/lateral stepping, even though nearly half scored in the normal category overall.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study population was 80% female and 78% white/non-Hispanic, limiting generalizability to acute or chronic mTBI phases and to male or underrepresented groups. Nearly half of the mTBI participants scored in the normal category on the Mini-BESTest, suggesting the test may have a ceiling effect or lack sensitivity for this specific population. The minimal detectable change and minimal clinically important difference for the Mini-BESTest have not been established in the mTBI population. Healthy controls were recruited via convenience sampling, and not all demographic data (e.g., race/ethnicity, prior concussion history) were captured. Multiple raters were used, though 47% of participants were assessed by a single primary rater.
Declared interests
The authors declared no conflicts of interest. The study was supported by a U.S. Government grant (Non-P.H.S.).
The easy way to misread this
Do not assume a normal Mini-BESTest total score rules out balance deficits in people with subacute concussion. Nearly half of the symptomatic mTBI participants in this study scored in the normal range on the total test, yet many still failed specific items like dual-task walking or reactive stepping.