David R Howell1, Louis R Osternig, Anita D Christie, Li-Shan Chou. 1. The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts (Dr Howell); Division of Sports Medicine, Department of Orthopedics, Children's Hospital Boston, Boston, Massachusetts (Dr Howell); and Department of Human Physiology, University of Oregon, Eugene (Drs Osternig, Christie, and Chou).
Abstract
OBJECTIVE: The effect of physical activity resumption on functional recovery following concussion is poorly understood. We sought to examine the relationship between physical activity resumption timing and gait stability 2 months following concussion. SETTING: Motion analysis laboratory. PARTICIPANTS: Twenty-nine individuals who sustained a concussion and were subsequently allowed to return to preinjury levels of physical activity within 2 months postinjury. DESIGN: Prospective cohort study. MAIN MEASURES: The return-to-activity day (RTA-day) was identified as the first day postinjury that each participant was medically cleared to resume regular physical activity. Whole-body center-of-mass (COM) motion during single-task and dual-task walking was assessed 2 months postinjury. Correlation coefficients were calculated between the RTA-day and single/dual-task gait stability as well as symptom severity measurements 2 months postinjury. RESULTS: Dual-task medial-lateral COM displacement (r = -0.52, P = .004) and peak medial-lateral COM velocity (r = -0.37, P = .048) were significantly correlated with RTA-day. Dual-task peak forward velocity and single-task gait stability measures were not significantly correlated with RTA-day. CONCLUSIONS: The time of RTA-day clearance, within a 2 months postinjury period, is significantly correlated with dual-task medial-lateral gait stability measured at the end of that period, suggesting that frontal plane gait stability recovery is sensitive to the timing of RTA-day.
OBJECTIVE: The effect of physical activity resumption on functional recovery following concussion is poorly understood. We sought to examine the relationship between physical activity resumption timing and gait stability 2 months following concussion. SETTING: Motion analysis laboratory. PARTICIPANTS: Twenty-nine individuals who sustained a concussion and were subsequently allowed to return to preinjury levels of physical activity within 2 months postinjury. DESIGN: Prospective cohort study. MAIN MEASURES: The return-to-activity day (RTA-day) was identified as the first day postinjury that each participant was medically cleared to resume regular physical activity. Whole-body center-of-mass (COM) motion during single-task and dual-task walking was assessed 2 months postinjury. Correlation coefficients were calculated between the RTA-day and single/dual-task gait stability as well as symptom severity measurements 2 months postinjury. RESULTS: Dual-task medial-lateral COM displacement (r = -0.52, P = .004) and peak medial-lateral COM velocity (r = -0.37, P = .048) were significantly correlated with RTA-day. Dual-task peak forward velocity and single-task gait stability measures were not significantly correlated with RTA-day. CONCLUSIONS: The time of RTA-day clearance, within a 2 months postinjury period, is significantly correlated with dual-task medial-lateral gait stability measured at the end of that period, suggesting that frontal plane gait stability recovery is sensitive to the timing of RTA-day.
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