The Concussion Balance Test, or COBALT, is a trademarked protocol for functional balance testing related to mild traumatic brain injury, or better known as concussion. The protocol is performed on Bertec force plate technology. It is designed to place higher demands on the vestibular and visual systems while maintaining balance.
The Modified COBALT (mCOBALT) has been designed for clinicians that do not have access to force plate technology. In the COBALT protocol, the clinician is determining how many errors the athlete has on each condition tested and the force plate is measuring the amount of sway the athlete has during each condition.
In the modified version, because there is not a force plate, the clinician will only record how many errors the athlete has during each condition tested as well as any subjective report of dizziness during any of the four conditions. The research showed a clinically significant increase in error rates when trying to maintain balance on a foam pad while rotating the head with eyes closed (vestibular) and focusing on an object during head and body rotation (visual). Thus, the mCOBALT is a valuable screening tool for clinicians to help determine if there is a balance impairment following a concussion and can help guide the most appropriate treatment plan. Both the COBALT and mCOBALT should also be used to monitor the athlete's recovery.
Additionally, the COBALT and mCOBALT protocol can also be used as a pre-screening assessment for athletes that are about to participate in a sport to identify pre-existing balance impairments before the season starts.
mCOBALT Competency Course
The mCOBALT Competency Course is a FREE educational offering that includes an instructional video and manual, a competency quiz and a Certificate of Completion.
See the course curriculum below:
Shelly Massingale, PT, MPT is the Senior Clinical Manager of the Banner Concussion Center. She is a Physical Therapist and is a specialist in vestibular and balance therapy. Shelly has been practicing physical therapy in the Outpatient Neurological setting for the past 18 years. She graduated from Pepperdine University with a Bachelor of Science degree in Kinesiology and continued her studies at the University of Southern California and graduated with a Master’s Degree in Physical Therapy. She began working in the outpatient department at Good Samaritan Hospital in September 1996. Since this time, she became certified in vestibular therapy from Emory University in March 2003 and was Advanced Certified at Emory University in August 2007. Over the years, she has developed skills in both vestibular therapy and in neurological rehabilitation. Shelly has been the Senior Clinical Manager with the Banner Concussion Center since its opening in April 2013. Since this time, she has been treating mild traumatic brain injury and post concussive syndrome from sports related injuries, motor vehicle accidents and all other types of injuries that cause mTBI. Shelly has recently authored two chapters in an upcoming book titled Quick Questions in Concussion which is scheduled for release in early 2015. She has lectured and trained therapy students as well as therapists on current treatments for concussion/mTBI. She is also involved in research regarding balance testing for athletes who suffer from mTBI.
Shelly is the author of three separate articles focusing on therapy for vestibular disorders. These articles have been published in medical journals such as Laryngoscope and in the journal of Otolaryngology-Head and Neck Surgery. Her research background is now extending out in the area of concussion/mTBI and balance testing and treatment. This research will continue to be pursued in her role at the Banner Concussion Center.
Concussion Get Started Kit
360 Neuro Health's Concussion Get Started Kit is designed to complement the mCOBALT Competency Course. It provides you the minimum tools needed to perform a balance test in your clinic. It includes a foam pad (standardized in density), measuring tape and head lamp.
Bertec COBALT Kit
The COBALT Kit provided by Bertec includes education, foam pad, wall chart, headlamp, measuring tape, and a laminated COBALT Excel Sheet and Error Card. The foam pad is standardized in both density and foot placement markers to increase reliability.
COBALT Kit + Force Plate Technology
The patented COBALT protocol includes a unique set of testing conditions that places high demands on the visual and vestibular systems that traditional static balance testing does not provide. The protocol is performed on Bertec Force Plate technology.