Influences Of Sleep Disturbances And Mild Traumatic Brain Injury On Gait Performance Among College Students

Abstract

Sleep disturbances from stress are common among college students. In addition, student athletes in contact sports (e.g., football and soccer) are at a higher risk of receiving a mild traumatic brain injury (mTBI). Stress-related sleep disturbances and mTBI may provoke cognitive and brain changes associated with gait abnormalities. PURPOSE: to examine the association between stress, sleep disturbances, mTBI and gait performance among college students. METHODS: The control group included 28 college students (11 males, 17 females, age: 22.6±3.2 yrs) and the mTBI group consisted of 12 NCAA Division II men’s and women’s soccer players who indicated a history of concussion (3 males, 9 females, age: 19.6±1.3 yrs). Participants were asked to perform gait analysis with an in-shoe pressure measurement system during and after the midterm exam. Cadence, step time, stride time, stance time and swing time were measured. Meanwhile, 14-days consecutive wrist actigraphy data and three sets of questionnaires were collected to assess their stress, sleep and fatigue. A mixed-design ANOVA was used to compare gait and sleep parameters of mTBI and control groups. RESULTS: The mTBI group had significantly shorter step time (0.54±0.01 vs. 0.58±0.01 s, p=.011) and stance time (0.66±0.01 vs. 0.70±0.01 s, p=.013) compared to the control group. The control group had significantly longer step time and stance time during the midterm exam than after the midterm exam. However, no significant differences of gait parameters were observed for the mTBI group during and after midterm exam. During the exam week, participants in both control and mTBI groups perceived moderate stress and reported 2-3 nights of sleep disturbances. Meanwhile, stress level was positively associated with sleep disturbances, poor daytime functioning, and poor activity correlation. CONCLUSION: Midterm exam as a stressor resulted in sleep disturbances in both mTBI and control groups. This stressor may also cause gait abnormalities of the control group, but not the mTBI group. Another interesting finding is that shorter step time and stance time were observed in the mTBI group. Nevertheless, further studies need to examine whether this is indeed due to mTBI, or the difference between student athletes and non-athletes. Supported by Office of Research and Scholarship at UT Tyler.