A preliminary study of longitudinal differences in local dynamic stability between recently concussed and healthy athletes during single and dual-task gait

Abstract

Concussed individuals commonly exhibit locomotor deficits during dual-task gait that can last substantially longer than clinical signs and symptoms. Previous studies have examined traditional stability measures, but nonlinear stability may offer further information about the health of the motor control system post-concussion. For up to one year post-concussion, this study longitudinally examined the local dynamic stability of five concussed athletes and four matched healthy controls during single- and dual-task gait. Local dynamic stability (LDS) was estimated using short-term, finite-time maximum Lyapunov exponents calculated from tri-axial accelerometers placed on the trunk and head. No main effects of group or task were found for LDS or stride time variability, but significant group*task interactions were apparent for trunk stability and stride time variability. Concussed individuals exhibited decreased trunk LDS and increased stride time variability during dual-task walking compared to matched controls despite similar single-task stability and variability. These preliminary results reinforce previous reports that concussions persistently affect dual-task processes even when single-tasks may be unaffected. Furthermore, the decreased local dynamic stability during dual-task gait indicates the concussed group attenuated local disturbances less than their healthy teammates. The decreased dynamic stability during dual-task activities was present after the athletes were cleared for competition and may be a contributing factor in the higher rates of musculoskeletal injuries in athletes post-concussion.

Sensor-Based Balance Measures Outperform Modified Balance Error Scoring System in Identifying Acute Concussion

“…While inertial sensors have been proposed for objective, clinical measures of balance 20 and validated with laboratory force platforms, 34,55 there are few studies that have used inertial sensor technology to quantify balance 10,15,28 or gait 9,12,22 after concussion. The current evidence from these studies is relatively consistent in showing that inertial sensor-based measures can detect abnormal balance or gait when clinical tests may not.…”

Impaired local dynamic stability during treadmill walking predicts future falls in patients with multiple sclerosis: A prospective cohort study

“…In addition to the gait problems commonly reported by PwMS (Bethoux and Bennett, 2011;Comber et al, 2016), cognitive impairments are also experienced by 65% of PwMS (Gianni et al, 2014;Gunn et al, 2013a). Although there are a number of studies which have investigated the effects of dual tasking on LDS of walking in various populations (Fino, 2016;Lamoth et al, 2011;van Schooten et al, 2016), no studies have yet investigated the association between dual task tests of LDS and fall risk in PwMS. In the elderly, the results of a previous study revealed that LDS of walking decreased under a cognitive dual task condition (Lamoth et al, 2011).…”

Inflection points in longitudinal models: Tracking recovery and return to play following concussion

“…We did not examine each model for the addition or removal of multiple predictors, but rather assessed the output of 2 model designs based on the central research question. Many studies have attempted to track the recovery of balance and gait in concussed athletes . In essence, they have compared the performance of healthy controls to concussed athletes over a particular timeline that may have included the point that athletes return to play.…”

“…Many studies have attempted to track the recovery of balance and gait in concussed athletes. [2][3][4][5][6][7][8]17 In essence, they have compared the performance of healthy controls to concussed athletes over a particular timeline that may have included the point that athletes return to play. Longitudinal assessments can provide an overall scope of changes (or lack thereof) across the timeline.…”

“…Longitudinal study designs have become a popular method of tracking the recovery of concussed persons and athletes over time. These methods have been used broadly within balance and gait‐based research, aimed at evaluating subtle deficits affected by concussion . While these studies have provided valuable insights into recovery following concussion, there are contrasting findings from studies using different methods and testing timelines.…”