Citation

Howell DR, Brilliant A, Berkstresser B, Wang F, Fraser J, Meehan W. J. Neurotrauma 2017; 34(23): 3288-3294.

Affiliation

Boston Children's Hospital , Sports Medicine , Sports Concussion Clinic , 319 Longwood Ave, Floor 6 , Boston, Massachusetts, United States , 02115 ; William.Meehan@childrens.harvard.edu.

Copyright

(Copyright © 2017, Mary Ann Liebert Publishers)

DOI

unavailable

PMID

28895490

Abstract

Quantitative gait measurements can identify persistent post-concussion impairments. However, their prognostic utility after injury to identify the likelihood of prolonged concussion symptoms remains unknown. Our objective was to examine if dual-task gait performance measures are independently associated with persistent (> 28 days) concussion symptoms among a sample of athletes. Sixty individuals diagnosed with a sport-related concussion were assessed within 10 days of their injury. Each participant completed a post-concussion symptom scale, injury history questionnaire, and a single/dual-task gait examination. They were followed until they no longer reported symptoms, and the duration of time required for symptom resolution was calculated. A binary multivariable logistic regression model determined the independent association between dual-task gait and symptom duration (≤28 days vs. > 28 days) while controlling for the effect of gender, age, symptom severity, injury-to-examination time, and history of concussion. Seventeen (28%) participants reported a symptom duration longer than 28 days. The dual-task cost for average gait speed (-25.9±9.5% vs. -19.8±8.9%; p=.027) and cadence (-18.0±2.9% vs. -12.0±7.7%; p=.029) was significantly greater among participants who experienced symptoms for more than 28 days. After adjusting for potential confounding variables, greater dual-task average gait speed costs were independently associated with prolonged symptom duration (aOR= 0.908; 95% CI= 0.835-0.987). Examinations of dual-task gait may provide useful information during multifaceted concussion examinations. Quantitative assessments that simultaneously test multiple domains, such as dual-tasks, may be clinically valuable after a concussion to identify those more likely to experience symptoms for more than 28 days after injury.

Language: en

Keywords

LOCOMOTOR FUNCTION; PEDIATRIC BRAIN INJURY; PROSPECTIVE STUDY; TRAUMATIC BRAIN INJURY