title: The Effect of Prior Concussion History on Dual-Task Gait following a Concussion.
abstract: Sustaining repeated concussions has been associated with worse outcomes after additional injuries. This effect has been identified using symptom inventories and neurocognitive tests; however, few investigations have examined how a prior concussion history affects gait soon after a subsequent concussion. We examined the gait characteristics of athletes with no documented concussion history (n = 31), athletes recovering from their first lifetime concussion (n = 15), and athletes recovering from their second or greater lifetime concussion (n = 22). All participants completed a single-task and dual-task gait examination, a medical history questionnaire, and a postconcussion symptom scale. Multivariate analyses of covariance (MANCOVA) models were used to evaluate mean gait differences among groups, and Spearman's ρ analyses were used to assess correlations between the number of lifetime concussions and gait characteristics. Patients reporting to the clinic with their second or greater lifetime concussion demonstrated smaller stride lengths than healthy control participants during dual-task walking (p = 0.01; d = 0.70). A moderate but insignificant correlation was detected between dual-task gait speed and the number of prior concussions (ρ = 0.41, p = 0.07). These results indicate that a cumulative effect of concussions across the lifetime may contribute to worsening dual-task dynamic motor function after concussion.
authors.affiliation: 1 The Micheli Center for Sports Injury Prevention , Waltham, Massachusetts.|2 Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital , Boston, Massachusetts.|3 Brain Injury Center, Boston Children's Hospital , Boston, Massachusetts.
authors.forename: David R
authors.initials: DR
authors.lastname: Howell
authors.affiliation: 2 Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital , Boston, Massachusetts.|3 Brain Injury Center, Boston Children's Hospital , Boston, Massachusetts.|4 Department of Orthopaedic Surgery, Harvard Medical School , Boston, Massachusetts.
authors.forename: Michael
authors.initials: M
authors.lastname: Beasley
authors.affiliation: 1 The Micheli Center for Sports Injury Prevention , Waltham, Massachusetts.|2 Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital , Boston, Massachusetts.|3 Brain Injury Center, Boston Children's Hospital , Boston, Massachusetts.|4 Department of Orthopaedic Surgery, Harvard Medical School , Boston, Massachusetts.
authors.forename: Lisa
authors.initials: L
authors.lastname: Vopat
authors.affiliation: 1 The Micheli Center for Sports Injury Prevention , Waltham, Massachusetts.|2 Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital , Boston, Massachusetts.|3 Brain Injury Center, Boston Children's Hospital , Boston, Massachusetts.|4 Department of Orthopaedic Surgery, Harvard Medical School , Boston, Massachusetts.|5 Department of Pediatrics, Harvard Medical School , Boston, Massachusetts.
authors.forename: William P
authors.initials: WP
authors.lastname: Meehan
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000150:complications / Q000503:physiopathology*; D001924:Brain Concussion / Q000150:complications / Q000503:physiopathology*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D011597:Psychomotor Performance / Q000502:physiology*
keywords: concussion; dual-task; gait; locomotion; mild traumatic brain injury