Robert C Lynall1, J Troy Blackburn2, Kevin M Guskiewicz3, Stephen W Marshall4, Prudence Plummer5, Jason P Mihalik3. 1. UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, United States; Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, United States; Human Movement Science Curriculum, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, United States. Electronic address: rlynall@uga.edu. 2. Human Movement Science Curriculum, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, United States; Neuromuscular Research Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, United States. 3. Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, United States; Human Movement Science Curriculum, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, United States. 4. Department of Epidemiology (Gillings School of Global Public Health) and Injury Prevention Research Center, University of North Carolina at Chapel Hill, United States. 5. Human Movement Science Curriculum, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, United States; Division of Physical Therapy, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, United States.
Abstract
OBJECTIVES: Despite evidence for increased musculoskeletal injury after concussion recovery, there is a lack of dynamic balance assessments that could inform management and research into this increased injury risk post-concussion. Our purpose was to identify tandem gait dynamic balance deficits in recreational athletes with a concussion history within the past 18-months compared to matched controls. DESIGN: Cross-sectional, laboratory study. METHODS: Fifteen participants with a concussion history (age: 19.7±0.9years; 9 females; median time since concussion 126 days, range 28-432 days), and 15 matched controls (19.7±1.6years; 9 females) with no recent concussion history participated. We measured center-of-pressure (COP) outcomes (velocity, path length, speed, dual-task cost) under 4 tandem gait conditions: (1) tandem gait, (2) tandem gait, eyes closed, (3) tandem gait, eyes open, cognitive distraction, and (4) tandem gait, eyes closed, cognitive distraction. RESULTS: The concussion history group demonstrated slower tandem gait velocity compared to the control group (4.0cm/s difference), thus velocity was used as a covariate when analyzing COP path length and speed. The concussion history group (23.5%) demonstrated greater COP speed dual-task cost than the control group (16.3%) during the eyes closed dual-task condition. No other comparisons were statistically significant. CONCLUSIONS: There may be subtle dynamic balance differences during tandem gait that are detectable after return-to-activity following concussion, but the clinical significance of these findings is unclear. Longitudinal investigations should identify acute movement deficits in varying visual and cognitive scenarios after concussion in comparison with recovery on traditional concussion assessment tools while also recording musculoskeletal injury outcomes.
OBJECTIVES: Despite evidence for increased musculoskeletal injury after concussion recovery, there is a lack of dynamic balance assessments that could inform management and research into this increased injury risk post-concussion. Our purpose was to identify tandem gait dynamic balance deficits in recreational athletes with a concussion history within the past 18-months compared to matched controls. DESIGN: Cross-sectional, laboratory study. METHODS: Fifteen participants with a concussion history (age: 19.7±0.9years; 9 females; median time since concussion 126 days, range 28-432 days), and 15 matched controls (19.7±1.6years; 9 females) with no recent concussion history participated. We measured center-of-pressure (COP) outcomes (velocity, path length, speed, dual-task cost) under 4 tandem gait conditions: (1) tandem gait, (2) tandem gait, eyes closed, (3) tandem gait, eyes open, cognitive distraction, and (4) tandem gait, eyes closed, cognitive distraction. RESULTS: The concussion history group demonstrated slower tandem gait velocity compared to the control group (4.0cm/s difference), thus velocity was used as a covariate when analyzing COP path length and speed. The concussion history group (23.5%) demonstrated greater COP speed dual-task cost than the control group (16.3%) during the eyes closed dual-task condition. No other comparisons were statistically significant. CONCLUSIONS: There may be subtle dynamic balance differences during tandem gait that are detectable after return-to-activity following concussion, but the clinical significance of these findings is unclear. Longitudinal investigations should identify acute movement deficits in varying visual and cognitive scenarios after concussion in comparison with recovery on traditional concussion assessment tools while also recording musculoskeletal injury outcomes.
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