title: Adolescents demonstrate greater gait balance control deficits after concussion than young adults.
abstract: BACKGROUND
  Age has been described as a factor that affects recovery after concussion. The recommended management protocol is to treat adolescents in a more cautious manner than adults. However, few studies have prospectively and longitudinally assessed the way these age groups perform on motor tasks after concussion.
  
  
  OBJECTIVE
  To examine dual-task gait balance control deficits after concussion in a group of adolescents and young adults in reference to matched control subjects within 72 hours of injury and throughout 2 months after injury.
  
  
  METHODS
  Cohort study; Level of evidence, 2.
  
  
  METHODS
  Adolescents and young adults who sustained a concussion and individually matched controls completed a whole-body motion gait analysis while simultaneously performing a cognitive task. Subjects with concussion reported to the laboratory within 72 hours after injury and at the following time points: 1 week, 2 weeks, 1 month, and 2 months after injury. Control subjects completed the same protocol at similar time points. Gait balance control measurements included whole-body center-of-mass (COM) medial-lateral displacement/velocity and anterior velocity.
  
  
  RESULTS
  A total of 38 subjects with concussion, 19 young adults (mean ± SD age, 20.3 ± 2.4 years) and 19 adolescents (mean ± SD age, 15.1 ± 1.1 years), and 38 individually matched control subjects were tested. Within 72 hours of injury, adolescents displayed significantly greater COM medial-lateral displacement (P = .001) and peak velocity (P = .001) relative to their control group, and the young adult concussion group displayed significantly less peak COM anterior velocity than their control group (P = .01). Across the 2 months of testing, adolescents with concussion displayed significantly greater total COM medial-lateral displacement than did adolescent controls (P = .001), while young adults with concussion did not significantly differ from their matched controls (P = .07).
  
  
  CONCLUSIONS
  An examination of gait balance control during dual-task walking revealed that after concussion, in reference to matched controls, adolescents demonstrated greater gait balance control deficits than did young adults initially and throughout the 2-month postinjury period, supporting the recommendation of conservative management for adolescents after concussion.
authors.affiliation: Department of Human Physiology, University of Oregon, Eugene, Oregon, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Howell
authors.affiliation: Department of Human Physiology, University of Oregon, Eugene, Oregon, USA.
authors.forename: Louis R
authors.initials: LR
authors.lastname: Osternig
authors.affiliation: Department of Human Physiology, University of Oregon, Eugene, Oregon, USA chou@uoregon.edu.
authors.forename: Li-Shan
authors.initials: LS
authors.lastname: Chou
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001924:Brain Concussion / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D016022:Case-Control Studies; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D004856:Postural Balance / Q000502:physiology*; D011446:Prospective Studies; D012678:Sensation Disorders / Q000175:diagnosis / Q000503:physiopathology*; D057190:Stroop Test; D015599:Trauma Severity Indices; D016138:Walking / Q000502:physiology*; D055815:Young Adult
keywords: adolescence; cerebral concussion; development; postural balance