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J Sci Med Sport. 2018 Apr;21(4):358-362. doi: 10.1016/j.jsams.2017.08.004. Epub 2017 Aug 16.

The utility of instrumented dual-task gait and tablet-based neurocognitive measurements after concussion.

Author information

1
The Micheli Center for Sports Injury Prevention,USA; Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, USA; Brain Injury Center, Boston Children's Hospital, USA. Electronic address: David.Howell2@childrens.harvard.edu.
2
Department of Neurology, Beth Israel Deaconess Medical Center, USA.
3
Department of Kinesiology and Applied Physiology, University of Delaware, USA; Interdisciplinary program in Biomechanics and Movement Science, University of Delaware, USA.
4
Harvard University Health Service, USA.
5
The Micheli Center for Sports Injury Prevention,USA; Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, USA; Brain Injury Center, Boston Children's Hospital, USA; Department of Pediatrics and Orthopedic Surgery, Harvard Medical School, USA.

Abstract

OBJECTIVES:

Quantitative and non-invasive measurements acquired by neurocognitive or gait evaluations are useful concussion management components. Emerging technology has allowed for the development of portable and objective tests which may be potentially useful across many settings where evaluations take place. Our aim was to examine the association between instrumented dual-task gait and tablet-based neurocognitive outcome variables with an acute concussion.

DESIGN:

A total of 59 collegiate athletes were identified and tested within 5days of concussion (n=18, 50% female, 20±1years of age) or as a part of a baseline examination (n=41, 29% female, 19±1years of age).

METHODS:

Participants completed an instrumented dual-task gait evaluation and a tablet-based neurocognitive evaluation. Outcome variables were compared with t-tests, and a multivariable logistic regression model was constructed to identify the association between the presence of a concussion and test performance.

RESULTS:

Compared with controls, participants with concussion reported significantly more severe symptoms (PCSS=19.1±15.2 vs. 4.1±6.3; p<0.001), walked significantly slower during dual-task conditions (87.7±10.4cm/s vs. 98.1±15.4cm/s; p=0.01), and responded with significantly slower simple reaction times (305.2±32.4ms vs. 275.4±22.1ms; p<0.001). After adjusting for the effect of potential confounding variables, these three variables (more severe symptoms, slower walking speed, and slower reaction time) remained independently associated with concussion (adjusted odds ratios=1.181, 0.916, and 1.043, respectively).

CONCLUSIONS:

Relatively simple quantitative measurements of dual-task gait and reaction time may be useful and portable clinical tests in the multifaceted assessment of concussion.

KEYWORDS:

Locomotion; Mild traumatic brain injury; Neurocognitive test; Postural control

PMID:
28919121
DOI:
10.1016/j.jsams.2017.08.004
[Indexed for MEDLINE]

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