ROLE OF SENSOR PLATE ANALYSIS IN ASSESSING BALANCE IMPAIRMENTS AFTER MILD TRAUMATIC BRAIN INJURY: AN OBSERVATIONAL STUDY

Abstract

Background
Mild traumatic brain injury (mTBI), commonly referred to as concussion, is frequently encountered in
emergency, sports and neurological rehabilitation settings. Although classified as mild, patients may
continue to experience dizziness, unsteadiness, visual sensitivity and reduced balance confidence after
the acute stage. Balance control depends on the integration of vestibular, visual and somatosensory
inputs; therefore, even subtle disruption of central sensory processing after mTBI may lead to postural
instability. Conventional clinical balance scales are useful, but they may not detect hidden sway
abnormalities in higher-functioning patients.
Objective
To evaluate balance impairments in patients with mild traumatic brain injury using sensor plate
analysis and to compare its sensitivity with the Berg Balance Scale.
Methods
A prospective observational study was conducted among 60 participants diagnosed with mild
traumatic brain injury. Participants were recruited in the subacute phase after injury and assessed
using a clinical neurological examination, Berg Balance Scale and sensor plate analysis. Sensor plate
testing was performed during quiet standing under eyes-open and eyes-closed conditions. Each
condition was recorded for 30 seconds and repeated three times with rest intervals. The primary
sensor plate outcome was sway area. Descriptive statistics, paired t-test, Pearson correlation and
McNemar test were used for analysis, with significance set at p < 0.05.
Results
The mean age of participants was 32.82 ± 8.07 years. The mean Berg Balance Scale score was 49.08
± 3.03 out of 56, indicating near-normal functional balance in many participants. Mean eyes-open
sway area was 275.42 ± 68.91 mm², while mean eyes-closed sway area was 470.07 ± 101.40 mm².
Eyes-closed sway was significantly higher than eyes-open sway (paired t = 37.566, p = 0.0000),
suggesting increased visual dependence. The Berg Balance Scale detected impairment in 4
participants (6.7%), whereas sensor plate analysis detected impairment in 44 participants (73.3%).
McNemar test showed a statistically significant difference in detection pattern between the two
methods (p = 0.0000).
Conclusion
Sensor plate analysis was more sensitive than the Berg Balance Scale in identifying subtle balance
impairments after mild traumatic brain injury. The findings support the use of objective postural sway
assessment along with clinical balance testing to improve evaluation, rehabilitation planning and
return-to-activity decisions in patients with mTBI.