title: Monitoring recovery of gait balance control following concussion using an accelerometer.
abstract: Despite medical best-practice recommendations, no consistent standard exists to systematically monitor recovery from concussion. Studies utilizing camera-based systems have reported center-of-mass (COM) motion control deficits persisting in individuals with concussion up to two months post-injury. The use of an accelerometer may provide an efficient and sensitive method to monitor COM alterations following concussion that can be employed in clinical settings. This study examined: (1) frontal/sagittal plane acceleration characteristics during dual-task walking for individuals with concussion and healthy controls; and (2) the effectiveness of utilizing acceleration characteristics to classify concussed and healthy individuals via receiver operating characteristic (ROC) curve analyses. Individuals with concussion completed testing within 72 h as well as 1 week, 2 weeks, 1 month, and 2 months post-injury. Control subjects completed the same protocol in similar time increments. Participants walked and simultaneously completed a cognitive task while wearing an accelerometer attached to L5. Participants with concussion walked with significantly less peak medial-lateral acceleration during 55-75% gait cycle (p=0.04) throughout the testing period compared with controls. Moderate levels of sensitivity and specificity were found at the 72 h and 1 week testing times (sensitivity=0.70, specificity=0.71). ROC analysis revealed significant AUC values at the 72 h (AUC=0.889) and two week (AUC=0.810) time points. Accelerometer-derived measurements may assist in detecting frontal plane control deficits during dual-task walking post-concussion, consistent with camera-based studies. These initial findings demonstrate potential for using accelerometry as a tool for clinicians to monitor gait balance control following concussion.
authors.affiliation: Department of Human Physiology, University of Oregon, Eugene, OR, USA.
authors.forename: David
authors.initials: D
authors.lastname: Howell
authors.affiliation: Department of Human Physiology, University of Oregon, Eugene, OR, USA.
authors.forename: Louis
authors.initials: L
authors.lastname: Osternig
authors.affiliation: Department of Human Physiology, University of Oregon, Eugene, OR, USA. Electronic address: chou@uoregon.edu.
authors.forename: Li-Shan
authors.initials: LS
authors.lastname: Chou
mesh_terms: D061725:Accelerometry; D000293:Adolescent; D016022:Case-Control Studies; D005260:Female; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D008297:Male; D038223:Post-Concussion Syndrome / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D004856:Postural Balance; D012372:ROC Curve; D020127:Recovery of Function; D016138:Walking; D055815:Young Adult
keywords: Acceleration; Balance; Center-of-mass; Locomotion; Mild traumatic brain injury