Evidence of a conservative gait strategy in athletes with a history of concussions

Thomas A Buckley; Srikant Vallabhajosula; Jessie R Oldham; Barry A Munkasy; Kelsey M Evans; David A Krazeise; Caroline J Ketcham; Eric E Hall

doi:10.1016/j.jshs.2015.03.010

Evidence of a conservative gait strategy in athletes with a history of concussions

J Sport Health Sci. 2016 Dec;5(4):417-423. doi: 10.1016/j.jshs.2015.03.010. Epub 2015 Jun 12.

Authors

Thomas A Buckley¹, Srikant Vallabhajosula², Jessie R Oldham¹, Barry A Munkasy³, Kelsey M Evans³, David A Krazeise⁴, Caroline J Ketcham⁵, Eric E Hall⁵

Affiliations

¹ Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE 19716, USA.
² Department of Physical Therapy Education, Elon University, Elon, NC 27244, USA.
³ Department of Health and Kinesiology, Georgia Southern University, Statesboro, GA 30460, USA.
⁴ Department of Intercollegiate Athletics, Stetson University, DeLand, FL 32723, USA.
⁵ Department of Exercise Science, Elon University, Elon, NC 27244, USA.

Abstract

Background: A 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.

Methods: There 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.

Results: There 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.

Conclusion: This 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.

Keywords: Balance; Brain injury; Gait performance; Locomotion; Mild traumatic; Postural control; Postural stability; Variability.

Grants and funding

R15 NS070744/NS/NINDS NIH HHS/United States