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BACKGROUND: Balance function is a key indicator in the identification of and recovery from concussion. The NeuroCom Sensory Organization Test (SOT) is used to objectively quantify balance using input from the visual, vestibular, and somatosensory systems. Baseline tests are necessary for comparison post-concussion. PURPOSE: The primary purpose of this study was to establish baseline SOT measures for the population that will be useful in the concussion assessment, diagnosis, and return to duty decisions following a concussion. Secondary aims were to compare females and males as well as concussed versus non-concussed. To the knowledge of the authors these are the only published normative data for a highly-active military population ages 17-23. STUDY DESIGN: Cross-sectional study METHODS: Two hundred fifty-three (70 female and 183 male) cadets in a boxing course at a service academy were enrolled. The participants were evaluated on the SOT using the NeuroCom Balance Manager (Natus Medical Inc., Seattle, WA) and each condition, composite (COMP) score, and ratio score were recorded. RESULTS: No significant differences were observed in SOT COMP scores between females (COMP = 76.67 ± 7.25) and males (COMP = 76.57 ± 7.77), nor between participants with history of concussion (COMP = 75.83 ± 7.90) versus those never concussed (COMP = 76.75 ± 7.57). CONCLUSION: This study provides SOT reference values for young, healthy, active individuals, which will assist in the interpretation of individual scores for concussion diagnosis and recovery, as well as serve as baseline data for future studies. These data on 17-23-year-olds will add to the currently available normative values of 14-15-year-olds and 20-59-year-olds. LEVEL OF EVIDENCE: 4

INTRODUCTION: There is a large incidence of shoulder instability among active young athletes and military personnel. Shoulder stabilization surgery is the commonly employed intervention for treating individuals with instability. Following surgery, a substantial proportion of individuals experience acute post-operative pain, which is usually managed with opioid pain medications. Unfortunately, the extended use of opioid medications can have adverse effects that impair function and reduce military operational readiness, but there are currently few alternatives. However, battlefield acupuncture (BFA) is a minimally invasive therapy demonstrating promise as a non-pharmaceutical intervention for managing acute post-operative pain. METHODS: This is a parallel, two-arm, single-blind randomized clinical trial. The two independent variables are intervention (2 levels, standard physical therapy and standard physical therapy plus battlefield acupuncture) and time (5 levels, 24 h, 48 h, 72 h, 1 week, and 4 weeks post shoulder stabilization surgery). The primary dependent variables are worst and average pain as measured on the visual analog scale. Secondary outcomes include medication usage, Profile of Mood States, and Global Rating of Change. DISCUSSION: The magnitude of the effect of BFA is uncertain; current studies report confidence intervals of between-group differences that include minimal clinically important differences between intervention and control groups. The results of this study may help determine if BFA is an effective adjunct to physical therapy in reducing pain and opioid usage in acute pain conditions. TRIAL REGISTRATION: ClinicalTrials.gov NCT04094246. Registered on 16 September 2019.