Background

Impairments in gait and balance function are typical after concussion. There is evidence that these neuromuscular deficits persist past the typical time of symptom resolution. The ability to quantify these changes in gait and balance may provide useful information when making return to play decisions in clinical settings.

Research Question

Are changes in gait function and postural control evident across the course of a concussion management program?

Methods

A retrospective analysis of a convenience sample of 38 patients who were seen for concussion between October 2017 and May 2019 was performed. Gait and balance measures were assessed at their initial clinic visit post-injury and at their clearance visit using inertial measurement units. During dual-task walking trials, the medial-lateral motion of the center of mass and gait velocity were measured. Postural sway complexity and jerk index were measured during both eyes-open and eyes-closed balance trials.

Results

Paired samples t-tests and Wilcoxon signed rank tests were used to determine whether statistically significant changes occurred for the gait and balance variables, respectively. Medial-lateral sway decreased (4.4 ± 1.3 cm to 4.0 ± 1.2 cm, p = 0.018) and gait velocity increased (0.78 ± 0.23 m/s to 0.91 ± 0.18 m/s, p < 0.001) from initial to clearance testing. Jerk index decreased (6.41 ± 11.06 m²/s⁵ to 5.73 ± 4.28 m²/s⁵, p = 0.031) and (11.87 ± 26.42 m²/s⁵ to 7.87 ± 8.38 m²/s⁵, p = 0.003) from initial to clearance testing for the eyes-open and eyes-closed conditions, respectively. Complexity index increased (2.38 ± 1.08–2.86 ± 0.72, p = 0.010) from initial to clearance testing for the eyes-closed condition. There was no change in complexity index for the eyes-open condition.

Significance

These preliminary results support the potential use of measures of gait and postural control to assess recovery following a concussion in a clinical setting.

中文翻译：

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脑震荡后使用惯性测量单元评估步态和姿势控制

背景

震荡后典型的步态和平衡功能障碍。有证据表明，这些神经肌肉缺陷持续至症状缓解的典型时间。当在临床环境中做出比赛决策时，量化步态和平衡这些变化的能力可能会提供有用的信息。

研究问题

在脑震荡管理程序的整个过程中，步态功能和姿势控制的变化是否明显？

方法

回顾性分析了2017年10月至2019年5月期间发现的38例脑震荡患者的便利性样本。使用惯性测量装置在受伤后初次就诊时和走访时评估步态和平衡措施。在双任务步行试验中，测量了质心的内侧向运动和步态速度。在睁眼和闭眼平衡试验中均测量了姿势摇摆的复杂性和加速度率指数。

结果

配对样本t检验和Wilcoxon符号秩检验用于确定步态和平衡变量是否分别在统计学上发生了显着变化。 从初始测试到间隙测试 ，内侧-外侧摇摆减小（4.4±1.3 cm至4.0±1.2 cm，p = 0.018），步态速度增大（0.78±0.23 m / s至0.91±0.18 m / s，p <0.001）。冲击率降低（6.41±11.06 m ² / s ⁵至5.73±4.28 m ² / s ⁵，p  = 0.031）和（11.87±26.42 m ² / s ⁵至7.87±8.38 m ² / s ⁵，p = 0.003）从初始测试到间隙测试分别为睁眼和闭眼条件。 从闭眼试验的初始到清除测试，复杂度指数增加了（2.38±1.08–2.86±0.72，p = 0.010）。睁眼条件下的复杂性指数没有变化。

意义

这些初步结果支持在临床环境中脑震荡后评估步态和姿势控制措施的潜力。