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Objective Evaluate the effectiveness of an acute period of cognitive and physical rest on concussion. Participants 50 consecutive patients with diagnosed concussions. Design Participants were assessed before (N=25) and after (N=25) a policy change which incorporated cognitive and physical rest. The Rest group patients were withheld from activities, including classes, for the remainder of the injury day and the following day whereas the No-Rest group patients were not provided any post-injury accommodations. Main Measures Patients were assessed on a graded symptom checklist, Balance Error Scoring System, Standard Assessment of Concussion, and computerized neuropsychological tests. The number of days until each test achieved baseline values was compared between groups with independent sample t-test. Results The No-Rest group achieved asymptomatic status sooner than the Rest group (5.2±2.9 days and 3.9±1.9 days respectively, P=0.047). There were no differences between groups for time to baseline values on the balance error scoring system, standard assessment of concussion, computerized neuropsychological tests, or time to clinical recovery. Conclusion A prescribed day of cognitive and physical rest was not effective in reducing post-concussion recovery time. These results agree with a previous study and suggest that light activity post-concussion may not be deleterious to the concussion recovery process.

The purpose was to determine if planned gait termination can identify acute and lingering motor control strategy alterations in post-concussion individuals. Controls completed 2 standard gait and 5 planned gait termination trials once while concussed individuals were tested on Day-1 and Day-10 post-concussion. Dependent variables included gait velocity and normalized, relative to standard gait, peak propulsive and braking forces. Control and only Day-1 post-concussion gait velocity differed. Normalized peak propulsive and braking forces were altered on both Day-1 and Day-10. Altered propulsive and braking forces persisted despite all concussion participants achieving their baseline values on standard concussion clinical tests. Thus gait termination can detect both acute and lingering motor control strategy alterations following concussion.

BackgroundA history of 3 or more concussions is frequently associated with numerous short- and long-term neuropathologies. Impairments in postural control are a known acute consequence of concussion; however, limited evidence exists on the effects of multiple concussions on gait. The purpose of this study was to assess gait stepping characteristics in collegiate aged student-athletes based on concussion history.MethodsThere were 63 participants divided into 3 even groups based on concussion history: ≥3 concussions, 1–2 concussions, and 0 concussion. All participants completed 10 trials of gait on a 4.9 m instrumented walkway. The dependent variables of interest included both gait stepping characteristics (step velocity, length, and width, double support time, and the percentage of the gait cycle in stance) and coefficient of variability (CoV) measures (step length, time, and width). The gait stepping characteristics were compared first with a MANOVA with follow-up 1-way ANOVAs and Tukey post hoc tests as appropriate. The CoV measures were compared with 1-way ANOVAs and Tukey post hoc tests.ResultsThere were main effects for group for step velocity, length, width, and double support time. Overall, the 0 concussion group displayed typical healthy young gait parameters and performed significantly better than either concussion group. The 0 concussion group had a significantly greater step length CoV, but there were no differences in the step time or width CoV.ConclusionThis finding provides evidence of subtle impairments in postural control during gait among individuals with prior history of concussion which could be an early indicator of future neurological deficiencies. The limited difference in the variability measures is consistent with prior static stance studies and could suggest the individuals constrain their motor systems to reduce variability. Taken together, these findings suggest a conservative gait strategy which is adopted by individuals with a history of concussions.

A clinically and statistically significant difference in BESS performance was identified after a 90-day intercollegiate athletic season.