title: Dual-task gait differences in female and male adolescents following sport-related concussion.
abstract: Concussion may affect females and males differentially. Identification of gender-related differences after concussion, therefore, may help clinicians with individualized evaluations. We examined potential differences in dual-task gait between females and males after concussion. Thirty-five participants diagnosed with a concussion (49% female, mean age=15.0±2.1 years, 7.5±3.0 days post-injury) and 51 controls (51% female, mean age=14.4±2.1 years) completed a symptom inventory and single/dual-task gait assessment. The primary outcome variable, the dual-task cost, was calculated as the percent change between single-task and dual-task conditions to account for individual differences in spatio-temporal gait variables. No significant differences in symptom severity measured by the post-concussion symptom scale were observed between females (32.0±18.0) and males (27.8±18.2). Compared with males, adolescent females walked with significantly decreased cadence dual-task costs after concussion (-19.7%±10.0% vs. -11.3%±9.2%, p=0.007) when adjusted for age, height, and prior concussion history. No significant differences were found between female and male control groups on other dual-task cost gait measures. Females and males with concussion also walked with significantly shorter stride lengths than controls during single-task (females: 1.13±0.11m vs. 1.26±0.11m, p=0.001; males: 1.14±0.14m vs. 1.22±0.15m, p=0.04) and dual-task gait (females: 0.99±0.10m vs. 1.10±0.11m, p=0.001; males: 1.00±0.13m vs. 1.08±0.14m, p=0.04). Females demonstrated a significantly greater amount of cadence change between single-task and dual-task gait than males after a sport-related concussion. Thus, differential alterations may exist during gait among those with a concussion; gender may be one prominent factor affecting dual-task gait.
authors.affiliation: The Micheli Center for Sports Injury Prevention, Waltham, MA, United States; Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, Boston, MA, United States; Brain Injury Center, Boston Children's Hospital, Boston, MA, United States. Electronic address: David.Howell2@childrens.harvard.edu.
authors.forename: David R
authors.initials: DR
authors.lastname: Howell
authors.affiliation: The Micheli Center for Sports Injury Prevention, Waltham, MA, United States; Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, Boston, MA, United States; Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, United States.
authors.forename: Andrea
authors.initials: A
authors.lastname: Stracciolini
authors.affiliation: The Micheli Center for Sports Injury Prevention, Waltham, MA, United States; Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, Boston, MA, United States; Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, United States.
authors.forename: Ellen
authors.initials: E
authors.lastname: Geminiani
authors.affiliation: The Micheli Center for Sports Injury Prevention, Waltham, MA, United States; Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, Boston, MA, United States; Brain Injury Center, Boston Children's Hospital, Boston, MA, United States; Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, United States; Department of Pediatrics, Harvard Medical School, Boston, MA, United States.
authors.forename: William P
authors.initials: WP
authors.lastname: Meehan
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000150:complications / Q000503:physiopathology*; D001924:Brain Concussion / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D000073456:Multitasking Behavior / Q000502:physiology*; D013997:Time Factors; D016138:Walking / Q000502:physiology*
keywords: Brain concussion; Divided attention; Mild traumatic brain injury; Postural balance; Sex difference