Determine if collegiate athletes exhibit residual deficits in vestibular function at the time of unrestricted return to participation (RTP) following a sports-related concussion (SRC).

It has been well documented that afferent vestibular pathways are disrupted after SRC. This includes both the vestibular-ocular and vestibulospinal reflexes which mediate dynamic vision and postural stability. However, few studies have determined if vestibular function is recovered in athletes at the time of RTP from SRC. 

Twenty-six NCAA Division-I athletes (1.77±0.14 m, 92.81±31.30 kg, 10 females, 16 males) performed the Concussion Balance Test (COBALT), the Dynamic Visual Acuity Test (DVAT), and Gaze Stability Test (GST). Thirteen athletes were tested within 14 days of RTP following SRC. Thirteen athletes with no history of SRC were matched to the RTP group based on age, sex, and sport to serve as healthy controls (HC). Paired t-tests with corresponding effect sizes compared COBALT, DVAT, and GST scores between groups (SRC, HC). For all tests, the alpha level was set a priori at 0.10.

The SRC group demonstrated poorer postural stability on the COBALT based on greater total balance errors (SRC: 5.38±4.59; HC: 1.85±2.41, ES=0.98; p=0.02) and greater sway velocities on the eyes closed, headshake on foam condition (SRC: 1.30±0.50; HC:1.07±0.32, ES=0.55, p=0.05) and the visual motion sensitivity (VMS) task on foam condition (SRC: 1.02±0.31, HC: 0.90±0.15, ES=0.47, p=0.10). The SRC group demonstrated poorer DVAT scores in the leftward direction compared to HC (SRC: -0.11±0.09, HC: 0.02±0.10 ES=1.32, p=0.08).

Our preliminary findings suggest that collegiate athletes who return to participation from SRC may experience residual deficits in postural control and visual acuity with dynamic head movements that challenge the vestibular system. Therefore, objective measures of vestibular function may be beneficial to ensure postural control and visual acuity are restored at RTP following SRC.