Combat Sports Law

Presently CTE can only be diagnosed after death. But there are criteria for diagnosing suspected CTE in the living which is useful for research and other purposes. It is called Traumatic Encephalopathy Syndrome “TES”.

A recent study was published researching athletes with and without TES and seeing how they performed on double leg balance testing. The study found there was a ‘significant association’ of worse balance testing in the group with TES with the authors concluding “This pilot study provides preliminary evidence of a relationship between declining postural balance and a TES diagnosis among retired professional fighters with elevated RHI exposure.“

The article is titled Repetitive Head Impacts Among Professional Fighters: A Pilot Study Evaluating Traumatic Encephalopathy and Postural Balance and can be found here.

Below is the full abstract

Objectives

Clinical criteria for Traumatic Encephalopathy Syndrome (ccTES) were developed for research purposes to reflect the clinical symptoms of Chronic Traumatic Encephalopathy (CTE). The aims of this study were to 1) determine whether there was an association between the research diagnosis of TES and impaired postural balance among retired professional fighters, and 2) determine RHI exposure thresholds among both TES positive and TES negative groups in retired professional fighters when evaluating for balance impairment.

Methods

This was a pilot study evaluating postural balance among participants of the Professional Athletes Brain Health Study (PABHS). Among the cohort, 57 retired professional fighters met the criteria for inclusion in this study. A generalized linear model with generalized estimating equations was used to compare various balance measures longitudinally between fighters with and without TES.

Results

A significant association was observed between a TES diagnosis and worsening performance on double-leg balance assessments when stratifying by repetitive head impact (RHI) exposure thresholds. Additionally, elevated exposure to RHI was significantly associated with increased odds of developing TES; The odds for TES diagnosis were 563% (95% CI = 113, 1963; p-value = 0.0011) greater among athletes with 32 or more professional fights compared to athletes with less than 32 fights when stratifying by balance measures. Likewise, the odds for TES diagnosis were 43% (95% CI = 10, 102; p-value = 0.0439) greater with worsening double leg stance balance in athletes exposed to 32 or more fights.

Conclusion

This pilot study provides preliminary evidence of a relationship between declining postural balance and a TES diagnosis among retired professional fighters with elevated RHI exposure. Further research exploring more complex assessments such as the Functional Gait Assessment may be of benefit to improve clinical understanding of the relationship between TES, RHI, and balance.