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Examining Motor Tasks of Differing Complexity After Concussion in Adolescents.

Abstract：

OBJECTIVES:(1) To determine the effects of concussion-related motor impairments at different task complexities in isolation and with a cognitive dual-task and (2) to determine if self-reported balance deficits after concussion are associated with gait, quiet stance, or cognitive dual-task impairments. DESIGN:Cross-sectional study. SETTING:Sports medicine clinic. PARTICIPANTS:Adolescent athletes clinically diagnosed with a sport-related concussion and those without concussion. Forty-nine patients with concussion (mean age=14.9±1.9y; 51% female; tested 7.0±3.0d postinjury) and 65 control participants (mean age=14.9±1.6y; 52% female) completed the study (N=114). INTERVENTIONS:Athletes with concussion completed a single-task and dual-task standing and walking protocol within 14 days of injury and were compared to those without concussion. MAIN OUTCOME MEASURES:Outcome measures included gait speed, quiet stance (root mean square [RMS] coronal/sagittal plane sway), and cognitive performance (accuracy). Dual-task costs were calculated as the percentage change between single-task and dual-task conditions. Participants with concussion were then stratified by those who did and did not report subjective balance problems at the time of testing and compared using objective balance and gait metrics. RESULTS:The concussion group walked slower during dual-task gait than controls (0.83±0.17 m/s vs 0.92±0.15 m/s; Cohen's d=0.53). Dual-task quiet stance RMS sway values were similar for concussion and control groups in coronal (1.20±0.52 m/s-2 vs 1.26±0.65 m/s-2; d=0.09) and sagittal (0.56±0.24 m/s-2 vs 0.73±0.44 m/s-2; d=0.20) movement planes. The concussion participants with subjectively-reported balance problems had significantly greater walking speed dual-task costs than concussion participants without self-reported balance problems (-25±10% vs -19±9%; P=.02). CONCLUSIONS:Following concussion, adolescents demonstrate slower gait speeds, but similar quiet stance values relative to those without concussion. The study results indicate that tasks requiring greater motor coordination may elicit greater alterations following a concussion.

journal_name

Arch Phys Med Rehabil

journal_title

Archives of physical medicine and rehabilitation

authors

Howell DR,Myer GD,Grooms D,Diekfuss J,Yuan W,Meehan WP 3rd

doi

10.1016/j.apmr.2018.07.441

subject

Has Abstract

pub_date

2019-04-01 00:00:00

pages

613-619

issue

eissn

0003-9993

issn

1532-821X

pii

S0003-9993(18)31182-1

journal_volume

100

pub_type

杂志文章

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Examining Motor Tasks of Differing Complexity After Concussion in Adolescents.