title: Altered integrated locomotor and cognitive function in elite athletes 30 days postconcussion: a preliminary study.
abstract: OBJECTIVE
  To begin to understand changes in locomotor navigation in elite athletes following concussion.
  
  
  METHODS
  Clinical measures and gait analysis were undertaken on average 37.33 days (SD = 4.8) postconcussion for 6 athletes as well as for a control group of athletes matched for age, sex, and team. The locomotor task consisted of walking at a self-selected speed along an unobstructed or obstructed path with and without a visual interference task. The trends for 4 dependent variables were described (2 for gait behavior and 2 for cognitive behavior). A principal component analysis was used to reduce data to root sources of variance among these variables. General group differences were tested with Wilcoxon matched-pairs tests on factorial scores.
  
  
  RESULTS
  Athletes with concussion were symptom free at the time of testing and their neuropsychological test results were not different from those of athletes in the control group. However, when the laboratory data between paired groups were compared, descriptive analyses suggested potential group differences in navigating the obstacle. The simultaneous Stroop task appeared to present difficulty for both groups. A significant group effect was found on the component of the factorial analysis that was highly loaded with both gait and cognitive variables (minimum clearance, Stroop task errors, and cognitive dual-task costs), generally supporting the descriptive analyses by suggesting that athletes with concussion do not navigate the targeted complex environments like the control group.
  
  
  CONCLUSIONS
  Athletes with concussion appear to still show navigational deficits in environments well after being considered fully recovered according to current return-to-play protocols. Although still preliminary and requiring further study, the present findings suggest that functional assessment within complex environment contexts could be considered before sending athletes back to play following a concussion, even in the absence of postconcussion symptoms or with normal clinical outcomes.
authors.affiliation: Université Laval, Quebec, Canada.
authors.forename: Philippe
authors.initials: P
authors.lastname: Fait
authors.forename: Bonnie
authors.initials: B
authors.lastname: Swaine
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Cantin
authors.forename: Jean
authors.initials: J
authors.lastname: Leblond
authors.forename: Bradford J
authors.initials: BJ
authors.lastname: McFadyen
mesh_terms: D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000503:physiopathology; D054874:Athletic Performance; D001924:Brain Concussion / Q000175:diagnosis* / Q000503:physiopathology; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000175:diagnosis*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D009483:Neuropsychological Tests; D038223:Post-Concussion Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D004856:Postural Balance / Q000502:physiology; D011596:Psychomotor Disorders / Q000503:physiopathology; D020127:Recovery of Function / Q000502:physiology; D012016:Reference Values; D018709:Statistics, Nonparametric; D013997:Time Factors; D055815:Young Adult