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Citation
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Parrington L, Fino PC, Swanson CW, Murchison CF, Chesnutt J, King LA. J. Athl. Train. 2019; 54(4): 429-438. |
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Abstract
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CONTEXT: In longitudinal studies tracking recovery after concussion, researchers often have not considered the timing of return to play (RTP) as a factor in their designs, which can limit the understanding of how RTP may affect the analysis and resulting conclusions.
OBJECTIVE: To evaluate the recovery of balance and gait in concussed athletes using a novel linear mixed-model design that allows an inflection point to account for changes in trend that may occur after RTP.
DESIGN: Cohort study. SETTING: University athletics departments, applied field setting. PATIENTS OR OTHER PARTICIPANTS: Twenty-three concussed (5 women, 18 men; age = 20.1 ± 1.3 years) and 25 healthy control (6 women, 19 men; age = 20.9 ± 1.4 years) participants were studied. Participants were referred by their team athletic trainer. MAIN OUTCOME MEASURE(S): Measures consisted of the Balance Error Scoring System (BESS) total score, sway (instrumented root mean square of mediolateral sway), single-task gait speed, gait speed while simultaneously reading a handheld article (dual-task gait speed), dual-task cost of reading on gait speed, and dual-task cost of walking on reading.
RESULTS: We observed no significant effects or interactions for the BESS. Instrumented sway was worse in concussed participants, and a change in the recovery trend occurred after RTP. We observed group and time effects and group × time and group × RTP change interactions ( P ≤.046). No initial between-groups differences were found for single-task or dual-task gait. Both groups increased gait speed initially and then leveled off after the average RTP date. We noted time and RTP change effects and positive group × time interactions for both conditions ( P ≤.042) and a group × RTP change interaction for single-task gait speed ( P =.005). No significant effects or interactions were present for the dual-task cost of reading on gait speed or the dual-task cost of walking on reading.
CONCLUSIONS: Changes in the rate of recovery were coincident with the timing of RTP. Although we cannot suggest these changes were a result of the athletes returning to play, these findings demonstrate the need for further research to evaluate the effects of RTP on concussion recovery.
Language: en |