B-128: Acute Effects of Concussion on the Sway Medical System Balance and Cognitive Tests

Abstract

Objective: The Sway Medical Sports+ test battery is designed for use in the medical management of sport-related concussion. This study documents the acute effects of sports-related concussion in student-athletes on these tests of balance and cognitive functioning. Method/Data Selection: There were 665 athletes, aged 18 to 24, who completed pre-season baseline assessments using the Sway Medical Sports+ test battery, had been documented in the app by the clinician as having sustained a ‘clinically diagnosed concussion,’ and were assessed within three days of injury. All reported acute concussion symptoms consistent with the 2023 American Congress of Rehabilitation Medicine criteria for mild traumatic brain injury. The Sway Medical Sports+ battery includes a test of balance and postural stability and four cognitive tests: Reaction Time (a measure of simple visual motor reaction time), Impulse Control (a measure requiring choice reaction time within a go/no-go test), Inspection Time (a measure requiring simple visual inspection speed), and Memory (a measure of visual working memory and delayed recall). Results/Data Synthesis: Repeated-measures ANOVAs revealed significantly worse scores following a concussion compared with baseline, with all p-values <.005. Effect sizes were very large for the symptom total score (Cohen’s d=1.28), medium for the Balance (d=.46) and Reaction Time (d=-.47) modules, small for the Impulse Control (d=-.36) and Inspection Time (d=-.39) modules, and very small for the Memory module (d=.12). Conclusions: Future research is needed to refine the clinical methodology for using the Sway tests, particularly how best to incorporate base rates of low normative test scores alongside preseason and post-injury test score comparisons.