Motion analysis evaluation of adolescent athletes during dual-task walking following a concussion: A multicenter study

Background: Research suggests that dynamic balance in adolescents is compromised following concussion and may worsen if patients return to sport (RTS) too soon. Understanding if there are ongoing dynamic balance deficits in adolescents at the time of RTS clearance would determine if more complex motor tasks are necessary to facilitate safe RTS decisions. Research question: The purpose of this study was to determine if there were remaining dynamic balance deficits in concussed adolescents at the time of clearance for RTS. Methods: Sixteen concussed adolescent athletes (age 14.6 ± 1.8 years; 9 males; 57 ± 46 days post injury) performed a simple walking task as well as two split attention gait tasks (reciting months backwards and audio Stroop). The center of mass (COM) movement and walking velocity during these tasks was compared to a control group of 15 healthy non-concussed adolescent athletes (age 13.8 ± 1.4 years; 9 male). Results: The results indicated that there were no statistically significant differences between the two groups for any of the tasks. Height-normalized walking speed did not differ between groups during walking alone (control: 0.757 ± 0.119, concussed: 0.739 ± 0.108, p = 0.34), with the recitation task (control: 0.555 ± 0.095, concussed: 0.557 ± 0.143, p = 0.72), or with the Stroop task (control: 0.589 ± 0.129, concussed: 0.567 ± 0.141, p = 0.43). Similarly, height-normalized medial-lateral COM displacement did not differ between groups during walking alone (control: 0.027 ± 0.007, concussed: 0.028 ± 0.007, p = 0.98, with the recitation task (control: 0.037 ± 0.012, concussed: 0.0.037 ± 0.016, p = 0.82), or with the Stroop task (control: 0.032 ± 0.014, concussed: 0.033 ± 0.009, p = 0.891). Significance: These findings indicate that the patients were returned to sport when their dynamic balance was similar to controls suggesting that this cohort had recovered from their concussion. However, large variability in dynamic balance measures in both the patient and control groups may reflect ongoing neuromuscular development and requires further exploration.