Spatial orientation of attention and obstacle avoidance following concussion

Area of Science:

• Neuroscience
• Biomechanics
• Rehabilitation Science

Background:

• Re-injury after concussion poses significant risks, including permanent brain damage or death.
• Concussion recovery can extend up to a month post-injury, with ongoing neurological processes.
• Deficits in attention and gait control may persist beyond the acute phase of mild traumatic brain injury (mTBI).

Purpose of the Study:

• To investigate the relationship between visuospatial attention and obstacle avoidance during gait in individuals with recent mTBI.
• To determine if attentional deficits correlate with impaired gait parameters, specifically obstacle clearance, in the post-concussion period.
• To examine how these relationships evolve during the recovery phase up to one month post-injury.

Main Methods:

• Concussed (mTBI) and control subjects performed the Attentional Network Test (ANT) to assess attention.
• Participants completed obstacle crossing tasks during gait, both with and without a secondary attention-demanding task.
• Key dependent variables included reaction times from the ANT and obstacle clearance measurements during gait.

Main Results:

• Individuals with mTBI exhibited a statistically significant increase in obstacle contacts compared to controls.
• Spatial orientation of attention was deficient in concussed individuals, correlating with reduced leading foot obstacle clearance.
• The correlation between spatial attention and obstacle clearance weakened as recovery progressed in mTBI patients.

Conclusions:

• Patients with mTBI demonstrate impaired spatial attention, directly linked to reduced obstacle clearance during gait.
• This deficit increases the likelihood of obstacle contact and potential re-injury in individuals recovering from concussion.
• The findings underscore the importance of assessing and addressing attentional deficits in concussion rehabilitation to improve gait safety.