CONTEXT: In longitudinal studies tracking recovery after concussion, researchers often have not considered the timing of return to play (RTP) as a factor in their designs, which can limit the understanding of how RTP may affect the analysis and resulting conclusions. OBJECTIVE: To evaluate the recovery of balance and gait in concussed athletes using a novel linear mixed-model design that allows an inflection point to account for changes in trend that may occur after RTP. DESIGN: Cohort study. SETTING: University athletics departments, applied field setting. PATIENTS OR OTHER PARTICIPANTS: Twenty-three concussed (5 women, 18 men; age = 20.1 ± 1.3 years) and 25 healthy control (6 women, 19 men; age = 20.9 ± 1.4 years) participants were studied. Participants were referred by their team athletic trainers. MAIN OUTCOME MEASURE(S): Measures consisted of the Balance Error Scoring System (BESS) total score, sway (instrumented root mean square of mediolateral sway), single-task gait speed, gait speed while simultaneously reading a handheld article (dual-task gait speed), dual-task cost of reading on gait speed, and dual-task cost of walking on reading. RESULTS: We observed no significant effects or interactions for the BESS. Instrumented sway was worse in concussed participants, and a change in the recovery trend occurred after RTP. We observed group and time effects and group × time and group × RTP change interactions (P ≤ .046). No initial between-groups differences were found for single-task or dual-task gait. Both groups increased gait speed initially and then leveled off after the average RTP date. We noted time and RTP change effects and positive group × time interactions for both conditions (P ≤ .042) and a group × RTP change interaction for single-task gait speed (P = .005). No significant effects or interactions were present for the dual-task cost of reading on gait speed or the dual-task cost of walking on reading. CONCLUSIONS: Changes in the rate of recovery were coincident with the timing of RTP. Although we cannot suggest these changes were a result of the athletes returning to play, these findings demonstrate the need for further research to evaluate the effects of RTP on concussion recovery.
CONTEXT: In longitudinal studies tracking recovery after concussion, researchers often have not considered the timing of return to play (RTP) as a factor in their designs, which can limit the understanding of how RTP may affect the analysis and resulting conclusions. OBJECTIVE: To evaluate the recovery of balance and gait in concussed athletes using a novel linear mixed-model design that allows an inflection point to account for changes in trend that may occur after RTP. DESIGN: Cohort study. SETTING: University athletics departments, applied field setting. PATIENTS OR OTHER PARTICIPANTS: Twenty-three concussed (5 women, 18 men; age = 20.1 ± 1.3 years) and 25 healthy control (6 women, 19 men; age = 20.9 ± 1.4 years) participants were studied. Participants were referred by their team athletic trainers. MAIN OUTCOME MEASURE(S): Measures consisted of the Balance Error Scoring System (BESS) total score, sway (instrumented root mean square of mediolateral sway), single-task gait speed, gait speed while simultaneously reading a handheld article (dual-task gait speed), dual-task cost of reading on gait speed, and dual-task cost of walking on reading. RESULTS: We observed no significant effects or interactions for the BESS. Instrumented sway was worse in concussed participants, and a change in the recovery trend occurred after RTP. We observed group and time effects and group × time and group × RTP change interactions (P ≤ .046). No initial between-groups differences were found for single-task or dual-task gait. Both groups increased gait speed initially and then leveled off after the average RTP date. We noted time and RTP change effects and positive group × time interactions for both conditions (P ≤ .042) and a group × RTP change interaction for single-task gait speed (P = .005). No significant effects or interactions were present for the dual-task cost of reading on gait speed or the dual-task cost of walking on reading. CONCLUSIONS: Changes in the rate of recovery were coincident with the timing of RTP. Although we cannot suggest these changes were a result of the athletes returning to play, these findings demonstrate the need for further research to evaluate the effects of RTP on concussion recovery.
Authors: Tonya M Parker; Louis R Osternig; Heng-Ju Lee; Paul van Donkelaar; Li-Shan Chou Journal: Clin Biomech (Bristol, Avon) Date: 2005-01-28 Impact factor: 2.063
Authors: Michael McCrea; William B Barr; Kevin Guskiewicz; Christopher Randolph; Stephen W Marshall; Robert Cantu; James A Onate; James P Kelly Journal: J Int Neuropsychol Soc Date: 2005-01 Impact factor: 2.892
Authors: Arash Salarian; Heike Russmann; François J G Vingerhoets; Catherine Dehollain; Yves Blanc; Pierre R Burkhard; Kamiar Aminian Journal: IEEE Trans Biomed Eng Date: 2004-08 Impact factor: 4.538
Authors: Michael McCrea; Kevin M Guskiewicz; Stephen W Marshall; William Barr; Christopher Randolph; Robert C Cantu; James A Onate; Jingzhen Yang; James P Kelly Journal: JAMA Date: 2003-11-19 Impact factor: 56.272
Authors: Dylan Powell; Alan Godfrey; Lucy Parrington; Kody R Campbell; Laurie A King; Sam Stuart Journal: J Neuroeng Rehabil Date: 2022-05-26 Impact factor: 5.208
Authors: Molly F Charney; David R Howell; Corey Lanois; Tyler C Starr; Huijun Liao; Eduardo Coello; Katherine M Breedlove; William P Meehan; Inga Koerte; Alexander P Lin Journal: J Head Trauma Rehabil Date: 2020 Sep/Oct Impact factor: 3.117
Authors: Amanda Morris; Benjamin Cassidy; Ryan Pelo; Nora F Fino; Angela P Presson; Daniel M Cushman; Nicholas E Monson; Leland E Dibble; Peter C Fino Journal: Front Sports Act Living Date: 2020-10-29
Authors: Mark Matthews; William Johnston; Chris M Bleakley; Richard J Davies; Alan T Rankin; Michael Webb; Brian C Caulfield; H A P Archbold Journal: Am J Sports Med Date: 2021-03-17 Impact factor: 6.202
Authors: Anthony Dever; Dylan Powell; Lisa Graham; Rachel Mason; Julia Das; Steven J Marshall; Rodrigo Vitorio; Alan Godfrey; Samuel Stuart Journal: Sensors (Basel) Date: 2022-02-14 Impact factor: 3.576