Objectives To determine whether individuals who sustained a sports concussion would exhibit persistent impairments in gait and quiet standing compared to non-injured controls during a dual-task assessment . Design Systematic review and meta-analysis using individual participant data (IPD). Data sources The search strategy was applied across seven electronic bibliographic and grey literature databases: MEDLINE, EMBASE, CINAHL, SportDISCUS, PsycINFO, PsycARTICLES and Web of Science, from database inception until June 2017. Eligibility criteria for study selection Studies were included if; individuals with a sports concussion and non-injured controls were included as participants; a steady-state walking or static postural balance task was used as the primary motor task; dual-task performance was assessed with the addition of a secondary cognitive task; spatiotemporal, kinematic or kinetic outcome variables were reported, and; included studies comprised an observational study design with case–control matching. Data extraction and synthesis Our review is reported in line with the Preferred Reporting Items for Systematic review and Meta-Analyses-IPD Statement. We implemented the Risk of Bias Assessment tool for Non-randomised Studies to undertake an outcome-level risk of bias assessment using a domain-based tool. Study-level data were synthesised in one of three tiers depending on the availability and quality of data: (1) homogeneous IPD; (2) heterogeneous IPD and (3) aggregate data for inclusion in a descriptive synthesis. IPD were aggregated using a ‘one-stage’, random-effects model. Results 26 studies were included. IPD were available for 20 included studies. Consistently high and unclear risk of bias was identified for selection, detection, attrition, and reporting biases across studies. Individuals with a recent sports concussion walked with slower average walking speed (χ2=51.7; df=4; p<0.001; mean difference=0.06 m/s; 95% CI: 0.004 to 0.11) and greater frontal plane centre of mass displacement (χ2=10.3; df=4; p=0.036; mean difference −0.0039 m; 95% CI: −0.0075 to −0.0004) than controls when evaluated using a dual-task assessment up to 2 months following concussion. Summary/conclusions Our IPD evidence synthesis identifies that, when evaluated using a dual-task assessment, individuals who had incurred a sports concussion exhibited impairments in gait that persisted beyond reported standard clinical recovery timelines of 7–10 days. Dual-task assessment (with motion capture) may be a useful clinical assessment to evaluate recovery after sports concussion. Protocol pre-registration This systematic review was prospectively registered in PROSPERO CRD42017064861.

中文翻译：

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在运动脑震荡后 2 个月，脑震荡的运动员在认知运动双任务评估中比非脑震荡运动员走得慢，但在单任务评估中则不然：使用个体参与者数据的系统评价和荟萃分析

目的 确定在双重任务评估期间，与未受伤的对照组相比，遭受运动脑震荡的个体是否会在步态和安静站立方面表现出持续性损伤。使用个人参与者数据 (IPD) 设计系统审查和荟萃分析。数据来源 搜索策略应用于七个电子书目和灰色文献数据库：MEDLINE、EMBASE、CINAHL、SportDISCUS、PsycINFO、PsycARTICLES 和 Web of Science，从数据库开始到 2017 年 6 月。患有运动脑震荡和未受伤的对照者被包括为参与者；稳态步行或静态姿势平衡任务被用作主要的运动任务；双任务表现是通过增加一个次要的认知任务来评估的；报告了时空、运动学或动力学结果变量，并且；纳入的研究包括具有病例对照匹配的观察性研究设计。数据提取和综合 我们的审查报告符合系统审查的首选报告项目和 Meta-Analyses-IPD 声明。我们为非随机研究实施了偏倚风险评估工具，以使用基于领域的工具进行结果级别的偏倚风险评估。根据数据的可用性和质量，将研究级数据合成为三个层次之一：(1) 同质 IPD；(2) 异构 IPD 和 (3) 汇总数据以包含在描述性综合中。IPD 使用“单阶段”随机效应模型进行汇总。结果 共纳入 26 项研究。IPD 可用于 20 项纳入研究。跨研究的选择、检测、损耗和报告偏倚一直被确定为高且不明确的偏倚风险。最近患有运动脑震荡的个体以较慢的平均步行速度行走（χ2=51.7；df=4；p<0.001；平均差=0.06 m/s；95% CI：0.004 至 0.11）和更大的额面质心位移（ χ2=10.3；df=4；p=0.036；平均差异 -0.0039 m；95% CI：-0.0075 至 -0.0004）与脑震荡后最多 2 个月使用双任务评估评估的对照相比。总结/结论我们的 IPD 证据综合表明，当使用双任务评估进行评估时，遭受运动脑震荡的个体表现出步态障碍，其持续时间超过了报告的 7-10 天的标准临床恢复时间表。双任务评估（带动作捕捉）可能是一种有用的临床评估，可用于评估运动脑震荡后的恢复情况。方案预注册 本系统评价在 PROSPERO CRD42017064861 中前瞻性注册。