Purpose: Few studies have investigated recovery between sexes using objective outcome measures. Our purpose was to examine the independent association between biological sex and recovery of postconcussion gait among collegiate athletes.
Methods: We evaluated participants with a diagnosed concussion <7 d postinjury, and approximately 1.5 months and 3.5 months postinjury. Participants completed a single/dual-task gait evaluation and symptom inventory. During dual-task trials, they completed a mental task (backward subtraction, spelling, or month recitation). The primary outcome measure was height-adjusted gait velocity recovery, defined as achieving normal gait velocity using established values: >0.56 and >0.50 gait velocity (m·s)/height (m) under single and dual-task conditions, respectively. We used a multivariable Cox proportional hazard model to identify associations between sex and dual-task recovery, controlling for age, concussion history, symptom severity, and loss of consciousness at the time of injury.
Results: Ninety-four individuals participated in the study: 47 (50%) were female athletes (mean age = 20.1, SD = 1.3 yr) and 47 (50%) were male athletes (mean age = 20.3, SD = 1.3 yr). Sex was not independently associated with height-adjusted single-task gait velocity recovery after controlling for potential confounders (hazard ratio = 1.62, 95% confidence interval = 0.87-3.01). However, male sex was independently associated with longer dual-task gait recovery time after controlling for potential confounders (hazard ratio = 2.43, 95% confidence interval = 1.11-5.35).
Conclusion: Male athletes required a longer duration of time after concussion to achieve dual-task gait recovery than female athletes. Thus, functional dual-task abilities after concussion may be affected differentially by sex and should be accounted for within individualized concussion management strategies.