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Published on: January 20, 2019
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Impairments in Dynamic Postural Control across Concussion Clinical Milestones
Thomas Buckley1, Nicholas G Murray2, Barry A Munkasy3
1Department of Kinesiology and Applied Physiology, Interdisciplinary program in Biomechanics and Movement Science University of Delaware, Newark, Delaware, USA.
Journal of Neurotrauma
|July 18, 2020
Summary
Concussion recovery may not fully restore dynamic postural control, as gait initiation deficits persist even at return to participation. Athletes may return before neurophysiological recovery, increasing injury risk.
Area of Science:
- Neuroscience
- Sports Medicine
- Biomechanics
Background:
- Concussion is a common injury in collegiate athletes.
- Current return to participation (RTP) protocols may not adequately assess functional recovery.
- Gait initiation (GI) involves complex motor control and may reveal subtle post-concussion deficits.
Purpose of the Study:
- To longitudinally assess gait initiation (GI) performance in collegiate athletes after concussion.
- To compare GI performance across clinical recovery milestones, including return to participation (RTP).
- To determine if athletes exhibit persistent gait deficits despite meeting clinical recovery criteria.
Main Methods:
- 54 collegiate athletes (27 concussed, 27 controls) participated.
- Gait initiation (GI) performance was assessed at baseline and five post-concussion milestones.
- Six outcome measures of GI, including center of pressure (COP) and step kinematics, were analyzed.
Main Results:
- Significant persistent deficits in anticipatory postural adjustment (APA) and step kinematics were observed in concussed athletes.
- These deficits were present across clinical milestones and at the RTP day.
- 85.2-88.9% of concussed athletes exceeded reliable change indices (RCI) for at least one GI measure at RTP.
Conclusions:
- Dynamic postural control impairments, assessed via GI, persist long after clinical concussion recovery.
- Collegiate athletes may return to participation before complete neurophysiological recovery.
- This suggests an elevated risk for recurrent concussion or musculoskeletal injury.
