Dual-task gait differences in female and male adolescents following sport-related concussion

Howell, David R.; Stracciolini, Andrea; Geminiani, Ellen; Meehan, William P.

doi:10.1016/j.gaitpost.2017.03.034

Cited by 54 publications

(45 citation statements)

References 28 publications

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“…There were 14 prospective longitudinal studies,46–59 11 cross-sectional studies60–70 and one retrospective longitudinal study 71. Data for 1039 participants (concussed participants (n=516); control participants (n=523)) were included in this review.…”

Section: Resultsmentioning

confidence: 99%

“…In all, 21 studies assessed participants within 2 days46–51 53–63 to 1 week52 67 68 71 72 following concussion. Five studies assessed participants for the first time approximately 1 month or greater following concussion 64–66 69 70.…”

Section: Resultsmentioning

confidence: 99%

“…Walking was the most frequently used motor task 46–68. Three studies used quiet standing tasks conducted on a strain gauge force-plate71 or a Wii balance board 69 70.…”

Section: Resultsmentioning

confidence: 99%

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Concussed athletes walk slower than non-concussed athletes during cognitive-motor dual-task assessments but not during single-task assessments 2 months after sports concussion: a systematic review and meta-analysis using individual participant data

et al. 2019

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ObjectivesTo determine whether individuals who sustained a sports concussion would exhibit persistent impairments in gait and quiet standing compared to non-injured controls during a dual-task assessment .DesignSystematic review and meta-analysis using individual participant data (IPD).Data sourcesThe search strategy was applied across seven electronic bibliographic and grey literature databases: MEDLINE, EMBASE, CINAHL, SportDISCUS, PsycINFO, PsycARTICLES and Web of Science, from database inception until June 2017.Eligibility criteria for study selectionStudies were included if; individuals with a sports concussion and non-injured controls were included as participants; a steady-state walking or static postural balance task was used as the primary motor task; dual-task performance was assessed with the addition of a secondary cognitive task; spatiotemporal, kinematic or kinetic outcome variables were reported, and; included studies comprised an observational study design with case–control matching.Data extraction and synthesisOur review is reported in line with the Preferred Reporting Items for Systematic review and Meta-Analyses-IPD Statement. We implemented the Risk of Bias Assessment tool for Non-randomised Studies to undertake an outcome-level risk of bias assessment using a domain-based tool. Study-level data were synthesised in one of three tiers depending on the availability and quality of data: (1) homogeneous IPD; (2) heterogeneous IPD and (3) aggregate data for inclusion in a descriptive synthesis. IPD were aggregated using a ‘one-stage’, random-effects model.Results26 studies were included. IPD were available for 20 included studies. Consistently high and unclear risk of bias was identified for selection, detection, attrition, and reporting biases across studies. Individuals with a recent sports concussion walked with slower average walking speed (χ2=51.7; df=4; p<0.001; mean difference=0.06 m/s; 95% CI: 0.004 to 0.11) and greater frontal plane centre of mass displacement (χ2=10.3; df=4; p=0.036; mean difference −0.0039 m; 95% CI: −0.0075 to −0.0004) than controls when evaluated using a dual-task assessment up to 2 months following concussion.Summary/conclusionsOur IPD evidence synthesis identifies that, when evaluated using a dual-task assessment, individuals who had incurred a sports concussion exhibited impairments in gait that persisted beyond reported standard clinical recovery timelines of 7–10 days. Dual-task assessment (with motion capture) may be a useful clinical assessment to evaluate recovery after sports concussion.Protocol pre-registrationThis systematic review was prospectively registered in PROSPERO CRD42017064861.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Concussed athletes walk slower than non-concussed athletes during cognitive-motor dual-task assessments but not during single-task assessments 2 months after sports concussion: a systematic review and meta-analysis using individual participant data

et al. 2019

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“…23,48 Furthermore, it has been proposed to have better reliability and validity than the BESS and does not rely on subjective rater interpretation. 23 In addition, tandem gait can be used for a wide range of ages 46,49 and is clinician-friendly.…”

Section: Clinical Gait Assessmentmentioning

confidence: 99%

Clinical Assessments of Balance in Adults with Concussion: An Update

et al. 2019

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Postural instability is a cardinal indicator of concussion. Assessments of the postural control system range from clinical to laboratory tests that assess the balance of the individual. In a previous article regarding clinical assessment of balance in adults with concussion, we reviewed the importance of balance as a component in concussion evaluations. The purpose of this review article is to update the information previously published in 2014. Since 2014, research has provided evidence for the incorporation of dynamic methods for evaluating balance postconcussion with particular emphasis on sensory system integration and dual tasking. Therefore, this review will examine the current state of knowledge on how concussion injuries affect postural control, advancements in evaluating balance postconcussion, such as novel eye-tracking techniques, and current recommendations for best practices for balance assessment.

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“…As noted above, fMRI studies using dual-task paradigms have demonstrated recruitment of many neuroanatomical areas outside of the typical structures known to service certain cognitive functions. In addition, the introduction of a cognitive task while walking has been shown to distinguish concussed from non-concussed athletes and may be used as a paradigm for monitoring recovery post-concussion [94][95][96].…”

Section: Dual-tasksmentioning

confidence: 99%

Sports Concussion: A Clinical Overview

Gardner¹

2018

Sport and Exercise Science

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Concussion is an injury risk associated with participation in collision sports. It has been identified as a research priority for many contacts and collision sports governing bodies worldwide. However, concussion remains under-researched in terms of clinical translation from both experimental models to clinical understanding, and from clinical studies to sports policy. Currently, the clinical management of concussion is largely guided by the presence or absence of symptoms with recovery indicated once all post-injury symptoms have resolved. Management of concussion includes physical and cognitive rest until acute symptoms resolve, with a graded program of exertion implemented prior to medical clearance and return-to-play. Considering the potential sequelae, the heterogeneity of symptoms, and the lack of an intervention known to prevent concussion, it is not any wonder that concussion is one of the most complex and perplexing injuries faced by medical professionals, and why making the return-to-play decision can be quite challenging. This chapter will provide an overview of the current clinical management guidelines and research literature pertaining to identification and diagnosis of injury, acute and post-acute management, and return-to-play decision-making. The traditional standard assessment process (e.g., symptom reporting, cognitive assessment, balance testing), new methods and advanced technology (e.g., ocular-motor testing, neuroimaging techniques), and biomarkers (e.g., blood plasma and serum, fluid) have led to greater insights into sports concussion and will also be briefly explored in this chapter.

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Dual-task gait differences in female and male adolescents following sport-related concussion

Cited by 54 publications

References 28 publications

Concussed athletes walk slower than non-concussed athletes during cognitive-motor dual-task assessments but not during single-task assessments 2 months after sports concussion: a systematic review and meta-analysis using individual participant data

Concussed athletes walk slower than non-concussed athletes during cognitive-motor dual-task assessments but not during single-task assessments 2 months after sports concussion: a systematic review and meta-analysis using individual participant data

Clinical Assessments of Balance in Adults with Concussion: An Update

Sports Concussion: A Clinical Overview

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