Effect Of Prior Concussion History On Stabilization Of The Head During Gait

Abstract

Stabilization of the head is a subconscious priority to maintain postural stability during gait. Increased movements of the head during gait have been associated with reductions in gait stability within numerous neuropathological populations. Despite observed, persistent deficits in gait stability associated with concussion history, the ability to stabilize the head during gait has not been thoroughly explored within individuals with a history of concussion. PURPOSE: To determine the effect of a prior history of concussion on the ability to control movements of the head during gait. METHODS: Thirty-six healthy adults were divided based on whether they reported a prior history of concussion (n = 20) while those reporting no prior concussions served as controls (n = 16). Individuals with a history of concussion reported an average of 2.15 ± 1.42 previous injuries and an average of 8.28 ± 5.94 years since their most recent concussion. A wireless, triaxial accelerometer was affixed to the posterior aspect of the head to measure movements in all three planes of motion during gait. Participants were instructed to walk across a 20-foot path at a self-selected pace while looking straight ahead. RESULTS: Individuals with a history of concussion demonstrated significantly greater average head accelerations in the mediolateral (ML, p = 0.0004) and anteroposterior (AP, p < 0.0001) planes during gait. There were no significant differences between groups for accelerations in the vertical plane. CONCLUSION: The findings of the present study indicate that individuals with a prior history of concussion have a reduced capability to attenuate excessive movements in the AP and ML planes to stabilize the head during gait. These results support the notion that concussion is associated with impairments of postural control that persist for years following the initial trauma. The observed, unattenuated movement at the level of the head may contribute to vestibular impairments and increased risk of falls and secondary injuries that are commonly observed in cases of concussion.