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Differential Effects of Acute and Multiple Concussions on Gait Initiation Performance
Archives of Physical Medicine and Rehabilitation ( IF 4.3 ) Pub Date : 2020-08-01 , DOI: 10.1016/j.apmr.2020.03.018
Thomas A Buckley 1 , Barry A Munkasy 2 , David A Krazeise 3 , Jessie R Oldham 4 , Kelsey M Evans 5 , Brandy Clouse 6
Affiliation  

OBJECTIVE To identify the effect of acute and multiple concussions on gait initiation performance. DESIGN Cohort Study SETTING: University Research Center PARTICIPANTS: A population based sample of 45 participants divided into three groups: No Prior Concussion, >3 Prior Concussions, and Acute Concussion. The Acute Concussion participants were assessed within 24 hours of their concussion. Participants were matched based on 1) sport, 2) position, and 3) anthropometric measures. INTERVENTIONS Participants were tested on a single occasion and performed five trials of gait initiation on four force plates. The No Prior Concussion and >3 Prior Concussion groups were tested out of their primary athletic season. MAIN OUTCOME MEASURES The dependent variables were the posterior and lateral displacement and velocity of the center of pressure (COP) during the anticipatory postural adjustment phase and initial step kinematics (step length and step velocity). Comparisons between groups used a One-Way ANOVA with Tukey Post-Hoc when significant effects were identified and effect sizes were calculated. RESULTS There were significant effects for group for all six outcome measures with large effect sizes. Post-hoc tests identified differences between Acute Concussion and No Prior Concussion for all measures. The >3 Concussion group and No Prior History group were different for COP posterior displacement (4.91 + 1.09 cm and 4.91 + 1.09 cm respectively, p=0.032, d=0.91) and velocity (0.18 + 0.06 m/s and 0.27 + 0.08 m/s respectively, p=0.002, d=1.27). CONCLUSION There was continuum of performance identified whereby the Acute Concussion participants performed worse and the No Prior Concussion participants performed the best. The >3 Prior Concussion generally fell between these two groups, but only statistical significance on COP posterior displacement and velocity. These results suggest there may be subtle neurophysiological deficits present in collegiate student-athletes with >3 Prior Concussions and further investigation over the lifespan is warranted.

中文翻译:

急性和多次脑震荡对步态启动性能的不同影响

目的 确定急性和多发性脑震荡对步态启动性能的影响。设计队列研究设置:大学研究中心 参与者:基于人群的 45 名参与者样本,分为三组:无脑震荡、>3 次脑震荡和急性脑震荡。急性脑震荡参与者在脑震荡后 24 小时内接受评估。参与者根据 1) 运动、2) 位置和 3) 人体测量进行匹配。干预 参与者只接受了一次测试,并在四个测力板上进行了五次步态启动试验。没有事先脑震荡和>3 事先脑震荡组在他们的主要运动赛季进行了测试。主要结果测量因变量是预期姿势调整阶段和初始步进运动学(步长和步进速度)期间压力中心 (COP) 的后侧和横向位移和速度。当确定显着影响并计算影响大小时,组间比较使用单向方差分析和 Tukey Post-Hoc。结果 对于所有六项具有大效应量的结果测量,组都有显着影响。事后测试确定了所有措施的急性脑震荡和无脑震荡之间的差异。>3 脑震荡组和无既往史组的 COP 后移(分别为 4.91 + 1.09 cm 和 4.91 + 1.09 cm,p=0.032,d=0.91)和速度(0.18 + 0.06 m/s 和 0.27 + 0.08 m)不同/s 分别,p=0.002,d=1.27)。结论 确定了连续的表现,其中急性脑震荡参与者表现更差,而无脑震荡参与者表现最好。> 3 先验脑震荡通常落在这两组之间,但仅对 COP 后部位移和速度有统计意义。这些结果表明,患有 3 次以上脑震荡的大学生运动员可能存在细微的神经生理学缺陷,因此有必要对整个生命周期进行进一步调查。
更新日期:2020-08-01
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