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Gait And Cognitive Assessments Of Concussed Athletes During Dual-task Walking

2016; Lippincott Williams & Wilkins; Volume: 48; Linguagem: Inglês

10.1249/01.mss.0000487444.46664.17

1530-0315

Klarie M. Ake, Nathan D’Amico, Katelyn E. Grimes, Megan E. Mormile, Douglas W. Powell, Thomas A. Buckley, Barry A. Munkasy, Nicholas G. Murray,

Cardiovascular Effects of Exercise

Dual-task (DT) scenarios, which increase cognitive load, may be a method of assessing gait abnormalities in concussed athletes during walking. This may be a means of objectively differentiating between healthy and concussed athletes during the acute phase of recovery. PURPOSE: The purpose of this study was to examine the effect of DT scenarios on gait in concussed athletes (CA) within 48 hours of the concussive injury as compared to a group of healthy athletes. METHODS: Gait parameters of 24 collegiate athletes (14 male, 10 female, age: 19.7±1.4 years) with concussions were assessed within 48 hours of the injury and a gender-matched control group that consisted of 24 (14 male, 10 female, age: 18.6±1.3years) collegiate athletes using the GAITRite electronic walkway. All participants completed five DT gait trials which included mental math, attention, and spelling tasks. Gait velocity, cadence, average stride length, and right and left heel-to-heel base of support (HH BOS) values were measured, normalized to height, averaged, and further analyzed. The total answers for the separate DT scenarios and number correct were also assessed. RESULTS: The normalized variables of gait velocity, average stride length, and both right and left HH BOS were not significantly different between groups. Normalized cadence was significantly greater in the CA group, at 105 steps/min, compared to the healthy athletes at 97 steps/min (p=0.006). With regards to the cognitive tests, CA group provided significantly fewer total responses in months of the year (MOY) (4±2.1 answers) (p=.015) and days of the week (DOW) (6.5±1.9 answers) (p=0.019) tasks, compared to healthy (MOY: 6.5±4.2 answers; and DOY: 8.4±3.4 answers). CA also had fewer correct responses (3.3±2.0 answers) in the MOY task (p=0.005) compared to healthy athletes (6.1±4.2 answers). CONCLUSIONS: The increased cadence exhibited by CA may be a function of decreased attention to the accuracy of the DT presented and more focus on the motor (gait) task. This is supported by the fact that the CA had fewer total responses in two DT scenarios (MOY and DOW), and in MOY had fewer total correct responses. These data suggest concussed athletes may have reduced capacity to perform a cognitive and motor task simultaneously.