Dynamic Visual Stimulations Produced in a Controlled Virtual Reality Environment Reveals Long-Lasting Postural Deficits in Children With Mild Traumatic Brain Injury

Motor control deficits outlasting self-reported symptoms are often reported following mild traumatic brain injury (mTBI). The exact duration and nature of these deficits remains unknown. The current study aimed to compare postural responses to static or dynamic virtual visual inputs and during stand...

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Autores principales:	Thomas Romeas, Selma Greffou, Remy Allard, Robert Forget, Michelle McKerral, Jocelyn Faubert, Isabelle Gagnon
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	mild traumatic brain injury (mTBI) postural instability children virtual reality balance sensorimotor control Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/8bbd43ec20d540939181a2dcb80131d3
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spelling	oai:doaj.org-article:8bbd43ec20d540939181a2dcb80131d32021-11-30T20:55:41ZDynamic Visual Stimulations Produced in a Controlled Virtual Reality Environment Reveals Long-Lasting Postural Deficits in Children With Mild Traumatic Brain Injury1664-229510.3389/fneur.2021.596615https://doaj.org/article/8bbd43ec20d540939181a2dcb80131d32021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fneur.2021.596615/fullhttps://doaj.org/toc/1664-2295Motor control deficits outlasting self-reported symptoms are often reported following mild traumatic brain injury (mTBI). The exact duration and nature of these deficits remains unknown. The current study aimed to compare postural responses to static or dynamic virtual visual inputs and during standard clinical tests of balance in 38 children between 9 and 18 years-of-age, at 2 weeks, 3 and 12 months post-concussion. Body sway amplitude (BSA) and postural instability (vRMS) were measured in a 3D virtual reality (VR) tunnel (i.e., optic flow) moving in the antero-posterior direction in different conditions. Measures derived from standard clinical balance evaluations (BOT-2, Timed tasks) and post-concussion symptoms (PCSS-R) were also assessed. Results were compared to those of 38 healthy non-injured children following a similar testing schedule and matched according to age, gender, and premorbid level of physical activity. Results highlighted greater postural response with BSA and vRMS measures at 3 months post-mTBI, but not at 12 months when compared to controls, whereas no differences were observed in post-concussion symptoms between mTBI and controls at 3 and 12 months. These deficits were specifically identified using measures of postural response in reaction to 3D dynamic visual inputs in the VR paradigm, while items from the BOT-2 and the 3 timed tasks did not reveal deficits at any of the test sessions. PCSS-R scores correlated between sessions and with the most challenging condition of the BOT-2 and as well as with the timed tasks, but not with BSA and vRMS. Scores obtained in the most challenging conditions of clinical balance tests also correlated weakly with BSA and vRMS measures in the dynamic conditions. These preliminary findings suggest that using 3D dynamic visual inputs such as optic flow in a controlled VR environment could help detect subtle postural impairments and inspire the development of clinical tools to guide rehabilitation and return to play recommendations.Thomas RomeasThomas RomeasSelma GreffouRemy AllardRobert ForgetRobert ForgetMichelle McKerralJocelyn FaubertIsabelle GagnonIsabelle GagnonFrontiers Media S.A.articlemild traumatic brain injury (mTBI)postural instabilitychildrenvirtual realitybalancesensorimotor controlNeurology. Diseases of the nervous systemRC346-429ENFrontiers in Neurology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	mild traumatic brain injury (mTBI) postural instability children virtual reality balance sensorimotor control Neurology. Diseases of the nervous system RC346-429
spellingShingle	mild traumatic brain injury (mTBI) postural instability children virtual reality balance sensorimotor control Neurology. Diseases of the nervous system RC346-429 Thomas Romeas Thomas Romeas Selma Greffou Remy Allard Robert Forget Robert Forget Michelle McKerral Jocelyn Faubert Isabelle Gagnon Isabelle Gagnon Dynamic Visual Stimulations Produced in a Controlled Virtual Reality Environment Reveals Long-Lasting Postural Deficits in Children With Mild Traumatic Brain Injury
description	Motor control deficits outlasting self-reported symptoms are often reported following mild traumatic brain injury (mTBI). The exact duration and nature of these deficits remains unknown. The current study aimed to compare postural responses to static or dynamic virtual visual inputs and during standard clinical tests of balance in 38 children between 9 and 18 years-of-age, at 2 weeks, 3 and 12 months post-concussion. Body sway amplitude (BSA) and postural instability (vRMS) were measured in a 3D virtual reality (VR) tunnel (i.e., optic flow) moving in the antero-posterior direction in different conditions. Measures derived from standard clinical balance evaluations (BOT-2, Timed tasks) and post-concussion symptoms (PCSS-R) were also assessed. Results were compared to those of 38 healthy non-injured children following a similar testing schedule and matched according to age, gender, and premorbid level of physical activity. Results highlighted greater postural response with BSA and vRMS measures at 3 months post-mTBI, but not at 12 months when compared to controls, whereas no differences were observed in post-concussion symptoms between mTBI and controls at 3 and 12 months. These deficits were specifically identified using measures of postural response in reaction to 3D dynamic visual inputs in the VR paradigm, while items from the BOT-2 and the 3 timed tasks did not reveal deficits at any of the test sessions. PCSS-R scores correlated between sessions and with the most challenging condition of the BOT-2 and as well as with the timed tasks, but not with BSA and vRMS. Scores obtained in the most challenging conditions of clinical balance tests also correlated weakly with BSA and vRMS measures in the dynamic conditions. These preliminary findings suggest that using 3D dynamic visual inputs such as optic flow in a controlled VR environment could help detect subtle postural impairments and inspire the development of clinical tools to guide rehabilitation and return to play recommendations.
format	article
author	Thomas Romeas Thomas Romeas Selma Greffou Remy Allard Robert Forget Robert Forget Michelle McKerral Jocelyn Faubert Isabelle Gagnon Isabelle Gagnon
author_facet	Thomas Romeas Thomas Romeas Selma Greffou Remy Allard Robert Forget Robert Forget Michelle McKerral Jocelyn Faubert Isabelle Gagnon Isabelle Gagnon
author_sort	Thomas Romeas
title	Dynamic Visual Stimulations Produced in a Controlled Virtual Reality Environment Reveals Long-Lasting Postural Deficits in Children With Mild Traumatic Brain Injury
title_short	Dynamic Visual Stimulations Produced in a Controlled Virtual Reality Environment Reveals Long-Lasting Postural Deficits in Children With Mild Traumatic Brain Injury
title_full	Dynamic Visual Stimulations Produced in a Controlled Virtual Reality Environment Reveals Long-Lasting Postural Deficits in Children With Mild Traumatic Brain Injury
title_fullStr	Dynamic Visual Stimulations Produced in a Controlled Virtual Reality Environment Reveals Long-Lasting Postural Deficits in Children With Mild Traumatic Brain Injury
title_full_unstemmed	Dynamic Visual Stimulations Produced in a Controlled Virtual Reality Environment Reveals Long-Lasting Postural Deficits in Children With Mild Traumatic Brain Injury
title_sort	dynamic visual stimulations produced in a controlled virtual reality environment reveals long-lasting postural deficits in children with mild traumatic brain injury
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/8bbd43ec20d540939181a2dcb80131d3
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Dynamic Visual Stimulations Produced in a Controlled Virtual Reality Environment Reveals Long-Lasting Postural Deficits in Children With Mild Traumatic Brain Injury

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