Peter C Fino1, Lucy Parrington2, Will Pitt3, Douglas N Martini4, James C Chesnutt5, Li-Shan Chou3, Laurie A King6. 1. Department of Neurology, Oregon Health & Science University, United States; Veterans Affairs Portland Health Care System, United States. Electronic address: fino@ohsu.edu. 2. Department of Neurology, Oregon Health & Science University, United States. 3. Department of Human Physiology, University of Oregon, United States. 4. Department of Neurology, Oregon Health & Science University, United States; Veterans Affairs Portland Health Care System, United States. 5. Department of Orthopedics & Rehabilitation and Family Medicine, Oregon Health & Science University, United States. 6. Department of Neurology, Oregon Health & Science University, United States; National Center for Rehabilitative Auditory Research, Veterans Affairs Portland Health Care System, United States.
Abstract
BACKGROUND: While a growing number of studies have investigated the effects of concussion or mild traumatic brain injury (mTBI) on gait, many studies use different experimental paradigms and outcome measures. The path for translating experimental studies for objective clinical assessments of gait is unclear. RESEARCH QUESTION: This review asked 2 questions: 1) is gait abnormal after concussion/mTBI, and 2) what gait paradigms (single-task, dual-task, complex gait) detect abnormalities after concussion. METHODS: Data sources included MEDLINE/PubMed, Scopus, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) accessed on March 14, 2017. Original research articles reporting gait outcomes in people with concussion or mTBI were included. Studies of moderate, severe, or unspecified TBI, and studies without a comparator were excluded. RESULTS: After screening 233 articles, 38 studies were included and assigned to one or more sections based on the protocol and reported outcomes. Twenty-six articles reported single-task simple gait outcomes, 24 reported dual-task simple gait outcomes, 21 reported single-task complex gait outcomes, and 10 reported dual-task complex gait outcomes. SIGNIFICANCE: Overall, this review provides evidence for two conclusions: 1) gait is abnormal acutely after concussion/mTBI but generally resolves over time; and 2) the inconsistency of findings, small sample sizes, and small number of studies examining homogenous measures at the same time-period post-concussion highlight the need for replication across independent populations and investigators. Future research should concentrate on dual-task and complex gait tasks, as they showed promise for detecting abnormal locomotor function outside of the acute timeframe. Additionally, studies should provide detailed demographic and clinical characteristics to enable more refined comparisons across studies.
BACKGROUND: While a growing number of studies have investigated the effects of concussion or mild traumatic brain injury (mTBI) on gait, many studies use different experimental paradigms and outcome measures. The path for translating experimental studies for objective clinical assessments of gait is unclear. RESEARCH QUESTION: This review asked 2 questions: 1) is gait abnormal after concussion/mTBI, and 2) what gait paradigms (single-task, dual-task, complex gait) detect abnormalities after concussion. METHODS: Data sources included MEDLINE/PubMed, Scopus, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) accessed on March 14, 2017. Original research articles reporting gait outcomes in people with concussion or mTBI were included. Studies of moderate, severe, or unspecifiedTBI, and studies without a comparator were excluded. RESULTS: After screening 233 articles, 38 studies were included and assigned to one or more sections based on the protocol and reported outcomes. Twenty-six articles reported single-task simple gait outcomes, 24 reported dual-task simple gait outcomes, 21 reported single-task complex gait outcomes, and 10 reported dual-task complex gait outcomes. SIGNIFICANCE: Overall, this review provides evidence for two conclusions: 1) gait is abnormal acutely after concussion/mTBI but generally resolves over time; and 2) the inconsistency of findings, small sample sizes, and small number of studies examining homogenous measures at the same time-period post-concussion highlight the need for replication across independent populations and investigators. Future research should concentrate on dual-task and complex gait tasks, as they showed promise for detecting abnormal locomotor function outside of the acute timeframe. Additionally, studies should provide detailed demographic and clinical characteristics to enable more refined comparisons across studies.
Authors: Lucy Parrington; Peter C Fino; Clayton W Swanson; Charles F Murchison; James Chesnutt; Laurie A King Journal: J Athl Train Date: 2019-04-01 Impact factor: 2.860
Authors: David R Howell; Anna N Brilliant; Jessie R Oldham; Brant Berkstresser; Francis Wang; William P Meehan Journal: J Sci Med Sport Date: 2019-09-07 Impact factor: 4.319
Authors: David R Howell; Jessie Oldham; Corey Lanois; Inga Koerte; Alexander P Lin; Brant Berkstresser; Francis Wang; William P Meehan Journal: Med Sci Sports Exerc Date: 2020-05
Authors: Taylor M Yeates; H Gerry Taylor; Erin D Bigler; Nori M Minich; Ken Tang; Daniel M Cohen; Ann Bacevice; Leslie K Mihalov; Barbara Bangert; Nicholas A Zumberge; Keith Owen Yeates Journal: J Neurotrauma Date: 2021-04-05 Impact factor: 5.269
Authors: Daniel J Corwin; Catherine C McDonald; Kristy B Arbogast; Fairuz N Mohammed; Kristina B Metzger; Melissa R Pfeiffer; Declan A Patton; Colin M Huber; Susan S Margulies; Matthew F Grady; Christina L Master Journal: Med Sci Sports Exerc Date: 2020-03
Authors: Daniel J Corwin; Catherine C McDonald; Kristy B Arbogast; Fairuz N Mohammed; Matthew F Grady; Christina L Master Journal: Clin J Sport Med Date: 2021-06-22 Impact factor: 3.454