The effect of prior concussion history on dual-task gait following a concussion

Abstract

ObjectiveTo examine gait characteristics among patients following their first lifetime concussion, second or greater lifetime concussion, and individuals with no concussion history.DesignProspective observational study.SettingRegional sport-concussion clinic.ParticipantsFourteen patients presented following their first lifetime concussion (57% female; 15.6 [95% CI:=13.0, 17.2] years of age; 11.1 [8.3, 13.9] days post-concussion), 21 following their second or greater lifetime concussion (52% female; 16.9 [15.5, 18.4] years of age; 8.6 [6.2, 11.1] days post-concussion), and thirty-one controls without a concussion history (65% female; 15.0 [14.2, 15.8] years of age). Exclusion criteria included a current lower extremity injury or diagnosed learning disability.Interventions/independent variablesParticipants completed gait evaluations and medical history questionnaires. MANCOVAs evaluated between-group gait differences; correlations were calculated between the number of lifetime concussions and gait.Outcome measuresParticipants recorded their number of prior concussions. Three inertial sensors quantified single and dual-task gait; variables included average gait speed, cadence, and stride length.Main resultsDuring dual-task gait, patients reporting for their ≥ second lifetime concussion walked significantly slower (0.81 [0.75, 0.89] m/s vs. 0.92 [0.86, 0.97] m/s;p=0.009) and with smaller stride lengths (0.98 [0.92, 1.04] m vs. 1.08 [1.04, 1.13] m;p=0.02) compared to controls. A moderate correlation was detected between dual-task gait speed and the number of prior concussions (ρ= 0.44,p= 0.04).ConclusionsPatients with a prior concussion history demonstrated altered dual-task gait strategies relative to controls. Dual-task gait velocity and number of prior concussions were moderately correlated, suggesting a worsening effect from multiple concussions across the lifetime.Competing interestsNone.Dr. Meehan receives royalties from ABC-Clio publishing for the sale of his book,Kids, Sports, and Concussion: A guide for coaches and parents, and royalties from Wolters Kluwer for working as an author forUpToDate. He is under contract with ABC-Clio publishing for a future book entitled,Concussions, and with Springer International publishing for a future book entitled,Head and Neck Injuries in Young Athletes. His research is funded, in part, by a grant from the National Football League Players Association and by philanthropic support from the National Hockey League Alumni Association through the Corey C. Griffin Pro-Am Tournament. Drs. Howell, Beasley, and Vopat have no conflicts of interest to report.