The Association between Dual-Task Gait after Concussion and Prolonged Symptom Duration
Abstract
Quantitative gait measurements can identify persistent postconcussion 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 postconcussion symptom scale, an 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 >28 days. The dual-task cost for average gait speed (−25.9 ± 9.5% vs. −19.8 ± 8.9%; p = 0.027) and cadence (−18.0 ± 2.9% vs. −12.0 ± 7.7%; p = 0.029) was significantly greater among participants who experienced symptoms for >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 >28 days after injury.
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Information & Authors
Information
Published In
Journal of Neurotrauma
Volume 34 • Issue Number 23 • December 1, 2017
Pages: 3288 - 3294
PubMed: 28895490
Copyright
Copyright 2017, Mary Ann Liebert, Inc.
History
Published in print: December 1, 2017
Published online: 1 December 2017
Published ahead of print: 16 October 2017
Published ahead of production: 12 September 2017
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Author Disclosure Statement
This research was funded, in part, by ElMinda Ltd. Dr. Howell and Ms. Brilliant received research support from ElMinda Ltd. Dr. Meehan receives royalties from (1) ABC-Clio publishing for the sale of his books, Kids, Sports, and Concussion: A Guide for Coaches and Parents, and Concussions; (2) Springer International for the book Head and Neck Injuries in the Young Athlete; and (3) Wolters Kluwer for working as an author for UpToDate. His research is funded, in part, by philanthropic support from the National Hockey League Alumni Association through the Corey C. Griffin Pro-Am Tournament and by a grant from the Football Players Health Study at Harvard University, which is funded by the NFL Players Association. The remaining authors have no disclosures related to this study.
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