Visuomotor deficits during locomotion in previously concussed athletes 30 or more days following return to play

Abstract

Current protocols for returning athletes to play (RTP) center around resolution of physical symptoms of concussion. However, recent research has identified that balance and cognitive deficits persist beyond physical symptom recovery. Protocols that involve testing dynamic balance and visuomotor integration have been recommended as potential tools for better understanding of length of impairment following concussion. A dynamic, visuomotor paradigm was undertaken in the current study to assess decision making in athletes who had sustained a concussion >30 days before study participation and had been cleared to RTP (N = 10). Two obstacles created a gap that varied between 0.6 and 1.8× participants' individual shoulder width in open space. Participants made decisions to navigate through or deviate around the gap created by the two obstacles. The results revealed that previously concussed athletes were highly variable in their decision making and demonstrated variable Medial‐Lateral (ML) center of mass (COM) control when approaching the obstacles, when compared with nonconcussed, age‐matched controls. As such, they showed poor visuomotor control and decision making, as well as poor dynamic stability compared to controls. Visuomotor deficits were persistent in the sample of previously concussed individuals, well beyond deficits identified by current RTP standards. This study suggests that dynamic, visuomotor integration tasks may be of benefit to increase rigor in RTP protocols and increase safety of athletes returning to sport.

Measuring Soldier Performance During the Patrol-Exertion Multitask: Preliminary Validation of a Postconcussive Functional Return-to-Duty Metric

“…The PEMT and other AMMP tasks were designed to challenge integrated functional performance and reveal residual deficits that become evident when limited and shareable brain resources are deliberately stressed,31 but are neither diagnostic nor mechanistic. Multiple studies32, 33,34,35,36 have shown that postconcussive dual-task deficits in gait, obstacle clearance, and balance, measured in laboratory settings, persist over much longer time frames than cognitive deficits observed in single-task conditions. This type of concurrent multiple-domain testing is intended to reveal deficits in SMs that are not always evident from single-domain assessments.…”

Effects of Trekking Pole Use on Metabolic Cost in Novice Hikers on Steep Terrains

“…Considering that trekking poles affect walking speed [7,9,20], the control of speed could interfere the aim of this study. During a usual locomotion, human reduces and optimizes energy cost by continuous adjustments of the walking speed, stride length, and stride frequency [23][24][25][26]. And at a preferred walking speed, there were no age and sex differences of metabolic responses [27].…”

Chiropractic Management of Musculoskeletal Symptoms in a 14-Year-Old Hockey Player With Postconcussion Symptoms: A Case Report

“…To progress through these stages, the athlete must remain symptom free. 1,4,5 However, recent research has identified that balance dysfunction and cognitive deficits persist well beyond the physical symptoms of the recovery process. 5 The length of recovery following a concussion varies, lasting anywhere from 1 week to several months.…”

“…1,4,5 However, recent research has identified that balance dysfunction and cognitive deficits persist well beyond the physical symptoms of the recovery process. 5 The length of recovery following a concussion varies, lasting anywhere from 1 week to several months. 6,7 Risk factors that can lead to increased recovery time include a history of 1 or multiple concussions and a greater number, severity, and duration of symptoms after the injury.…”