A Preliminary Investigation

Abstract

Following concussion, persistent changes in cognition, balance and gait have been observed. However, it is unclear if concussion history affects obstacle crossing. PURPOSE: To assess the long-term effects of concussion on obstacle crossing. METHODS: College-aged participants (N=16) were divided into a control (n = 8) or previously concussed (n = 8) group based on self-report. Following consent, each participant was instructed to walk at a self-selected pace during two different gait conditions: an obstructed walk (C1) and an obstructed walk with a cognitive task (ie Brook’s Mental Task) (C2). The obstacle was set to 20% of the participants average leg length. Each participant completed five trials per condition. Data were collected using a 16-camera optical motion capture system. Obstacle toe clearance and joint kinematics were assessed for lead and trail legs. One-way ANOVAs and Cohen’s d effect sizes were calculated to compare toe clearance (cm) and joint kinematics (degrees) between groups. RESULTS: (control vs concussed) Lead foot toe clearance was significantly greater for the previously concussed for C1 (14.80 ± .02 vs 18.20 ± .03; p = .01; d = 1.29), while trending for C2 (17.02 ± .03 vs 20.24 ± .05; p = .09; d = .85). This trend was persistent but reduced for the trail foot for C1 (14.68 ± .05 vs 17.15 ± .05; p = .25; d = .54) and C2 (18.03 ± .04 vs 20.36 ± .05; p = .27; d = .53). Both lead and trail foot hip external rotation (Lead: -13.21 ± 8.87 vs -20.26 ± 6.60; p = .05; d = .96; Trail: -10.00 ± 4.53 vs -17.72 ± 5.96; p < .01; d = 1.53) were significantly different between groups for C1, with weaker trends in C2 (Lead: -16.65 ± 6.55 vs -19.31 ± 6.95; p = .34; d = .41; Trail: -10.58 ± 7.69 vs -14.27 ± 4.38; p = .16; d = .61). C1 trail foot knee extension reached significance between groups (9.09 ± 4.41 vs 4.27 ± 6.76; p = .04; d = .85), while trending in C1 lead foot (9.24 ± 4.67 vs 5.88 ± 5.12; p = .13; d = .72), and C2 (Lead: 5.73 ± 4.86 vs .91 ± 7.67; p = .08; d = .78; Trail: 10.25 ± 12.04 vs 6.31 ± 9.60; p = .80; d = .38). There was no significance or trend in knee flexion between groups for C1 or C2. CONCLUSION: These preliminary data suggest that young adults with a concussion history demonstrate greater obstacle toe clearance and altered kinematics. These changes mimic gait pattern changes in older adults. Though, how these gait alterations manifest across age is still unknown.