Youth With Concussion Have Less Adaptable Gait Patterns Than Their Uninjured Peers: Implications for Concussion Management.

Abstract

To compare cross-recurrence quantification analysis measurements obtained during gait between adolescents who sustained a diagnosed concussion within 14 days of assessment and healthy adolescents. Cross-sectional study. Youth athletes with concussion (n = 43; mean ± SD age, 14.4 ± 2.3 years; 56% female; tested median, 7 days post concussion) and healthy controls (n = 38; age, 14.9 ± 2.0 years; 55% female) completed a single-task and dual-task gait protocol while wearing a set of inertial sensors. We used cross-recurrence quantification analysis techniques to quantify the similarity between accelerations obtained from the sensor on the dorsum of each foot. Four outcome variables were compared between groups: percent determinism, average diagonal-line length, laminarity, and trapping time. Athletes with concussion had significantly higher percent determinism, laminarity, and trapping time than the control group in single-task and dual-task conditions (P<.05). Gait patterns, when simultaneously completing a secondary cognitive task (dual task), were no different from gait patterns under a single-task condition. Higher percent determinism, laminarity, and trapping time among athletes with concussion suggest that concussion may be associated with a more stuck and predictable gait pattern. These altered movement patterns may be one reason for underlying slower gait speeds that have been observed following concussion. J Orthop Sports Phys Ther 2020;50(8):438-446. Epub 22 May 2020. doi:10.2519/jospt.2020.9133.