Session Information
Session Title: AA 2022 Posters - Neurological Rehabilitation
Session Time: None. Available on demand.
Disclosures: Charles D. Kenyon, DO, MS, CSCS: No financial relationships or conflicts of interest
Objective: Vestibular dysfunction following concussion is associated with functional limitations and protracted recovery. Postural control (PC) is a complex sensorimotor task requiring integration of multiple systems. Sensory organization testing (SOT) is shown to reflect post-concussive impairments in PC, but clinical analysis methods are effective only in the acute period. The present study aims to characterize PC strategies during SOT in a population with subacute post-concussive vestibular dysfunction (PCVD) compared to healthy controls (HC) utilizing discrete wavelet transform analysis (DWT).
Design: Case-Control.
Setting: Clinical.
Participants: SCVD group: (21 patients, 12 Female, Age: 23.16 ± 4.67) with positive Vestibular Ocular Motor Screening (VOMS) at >30 days post-concussion. HC group: (34 patients, 20 Female, Age: 28.11 ± 4.46).
Interventions: Observational.
Main Outcome Measures: DWT analysis of SOT signals (postural sway) banded into frequencies representing mechanisms of visual, vestibular, cerebellar, and proprioception/muscular activity control. Energy content (EC) within each frequency-band was compared across SOT conditions and study groups to determine weighting of sensory systems in PC strategies.
Results: Compared to HC, the PCVD group demonstrated increased EC in the low-frequency bands (vision) and decreased EC in the mid-frequency bands (proprioception/cerebellar) during vision absent and sway-referenced vision conditions. EC changes from normal vision compared to absent vision and sway-referenced vision conditions between groups demonstrated increased EC in visual bands (absent vision: p = 0.001052) and decreased EC in cerebellar/proprioceptive bands (absent vision: p = 0.000514, sway-referenced vision: p = 0.00174) in the PCVD group.
Conclusions: Upregulation of visual PC with decreased utilization of cerebellar and proprioceptive strategies was found in the PCVD group during SOT compared to HC. Changes were noted during SOT conditions with both absent and unreliable visual input. These findings demonstrate a central over-reliance on visual input in subacute PCVD which may account for dizziness and visual motion sensitivity. Furthermore, sensory re-weighting treatment strategies may be effective in those with PCVD following concussion.
Level of Evidence: Level III
To cite this abstract in AMA style:
Kenyon CD, Sandlin D, Garrido JC, Risk B, Hurtado J, Jayanthi N, Gore R, Allen J. Altered Central Sensory Integration Strategies in Subacute Post-concussive Vestibular Dysfunction: A Discrete Wavelet Transform Analysis [abstract]. PM R. 2022; 14(S1)(suppl 1). https://pmrjabstracts.org/abstract/altered-central-sensory-integration-strategies-in-subacute-post-concussive-vestibular-dysfunction-a-discrete-wavelet-transform-analysis/. Accessed May 21, 2025.« Back to AAPM&R Annual Assembly 2022
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/altered-central-sensory-integration-strategies-in-subacute-post-concussive-vestibular-dysfunction-a-discrete-wavelet-transform-analysis/