OCLC: 808630123
Introduction: Recent literature has suggested that gait could potentially provide clinicians with a reliable way to determine if an athlete has sufficiently recovered from a concussion in order to return to participation. The Balance Error Scoring System has typically been used to determine if static and postural control have returned to baseline measurements. It has yet to be determined the level of gait recovery within 24 hours of sustaining a concussion (CD1), on the day the concussed athlete returns to BESS baseline (BBD), or the day they finally return to play (RTPD).
Objective: The purpose of this study was to compare a concussed athlete’s gait to non-concussed athletes and normal controls, on specific days of their recovery process.
Methods: In this study, 45 subjects were divided into groups; 15 concussed intercollegiate athletes (CONCs), 15 nonconcussed teammates (NONCs), and 15 normal controls (NORMs) who did not participate in an intercollegiate sport. The NONCs were matched according to sport and gender, and the NORMs were matched to gender of the CONCs. The subjects walked on the GAITRite® walkway, where gait velocity, cadence, step length, step width, and double leg support times were calculated. The NONCs and CONCs walked the same number of days as their CONC match, until the CONC returned to participation.
Results: Gait velocity showed significant group differences at CD1 (F= 3.670, p=.034), whereby CONCs had a mean gait velocity significantly less than the NORMs (1.21 + 0.16 m/s and 1.34 + 0.09 m/s respectively, p=.036). There were significant main effects for gait velocity, step length, step width, and double leg support times. Most of the subjects increased their gait velocity and step length (F=18.940 and p<.001, F=16.542 and p<.001), respectively) and decreased their double leg support times (F=14.395 and p<.001) between CD1 and BBD. Subjects from CD1 to RTPD showed increases in gait velocity and step length (F= 11.901 and p=.001, F=10.553 and p=.002, respectively), and decreases in step width and double leg support times (F=11.976 and p=.001, and F=10.583, p=.002, respectively). However, there were no significant differences for gait velocity, cadence, step length, step width, or double leg support times between CONC and NONC, CONC and NORM, or NONC and NORM from CD1 to BBD, BBD to RTPD, or from CD1 to RTPD.
Conclusion: These findings indicate that a concussed athlete shows slower gait velocity initially after a concussion at CD1, possibly indicating a conservative gait strategy that develops into normal gait patterns as BBD and RTPD occur. However, cadence, step length, step width, and double leg support times during single task walking may not be good indicators on whether an athlete has recovered their postural control. Therefore, it is recommended that a variety of concussion testing tools, including postural control measurements such as gait, be used to make a proper assessment of when the athlete may return to participation.