Identification of Post-Concussion Dual-Task Gait Abnormalities Using Normative Reference Values

Abstract

Our purpose was to identify the rate of abnormal single-task and dual-task gait performance acutely post-concussion relative to uninjured controls using previously established normative reference values. We examined athletes with a concussion (n=54; mean age=20.3±1.1 years of age, 46% female, tested 2.9±1.5 days post-injury) and healthy controls tested during their preseason baseline examination (n=60; 18.9±0.7 years of age, 37% female). Participants completed an instrumented single/dual-task gait evaluation. Outcome variables included average walking speed, cadence, and step length. A significantly greater number of those with concussion walked with abnormal dual-task gait speed compared to the control group (56% vs. 30%; p= 0.008). After adjusting for potential confounding variables (age, concussion history, symptom severity, and sleep), concussion was associated with lower dual-task gait speed (β=-0.150; 95% CI=-0.252,-0.047), cadence (β= -8.179; 95% CI=-14.49,-1.871), and stride length (β=-0.109; 95% CI=-0.204,-0.014). Although group analyses indicated that those with a concussion performed worse on single-task and dual-task gait compared to controls, a higher rate of abnormal gait was detected for the concussion group compared to the control group for dual-task gait speed only. Dual-task gait speed, therefore, may be considered as a measure to compare against normative values to detect post-concussion impairments.

Keywords: gait; locomotion; mild traumatic brain injury; postural balance; young adult.