Decreased Anticipatory Postural Adjustments During Gait Initiation Acutely Postconcussion

Overview

Journal Arch Phys Med Rehabil

Specialty Rehabilitation Medicine

Date 2017 Jun 7

PMID 28583462

Citations 13

Authors

Thomas A Buckley

Jessie R Oldham

Barry A Munkasy

Kelsey M Evans

Affiliations

Soon will be listed here.

Abstract

Objective: To investigate anticipatory postural adjustments (APAs) during the transitional movement task of gait initiation (GI) in individuals acutely after a concussion.

Design: Cohort study.

Setting: University research center.

Participants: A population-based sample of participants (N=84) divided into 2 equal groups of acutely postconcussion and healthy student athletes.

Intervention: Participants were tested on 2 occasions: a preinjury baseline test and then the concussion group was retested acutely postconcussion and the healthy student athlete group again at a similar time. All participants completed 5 trials of GI on 4 forceplates.

Main Outcome Measures: The dependent variables were the displacement and velocity of the center of pressure (COP) during the APA phase and initial step kinematics. Comparisons were made with a 2 (group) × 2 (time) repeated-measures analysis of variance.

Results: There was a significant interaction for COP posterior displacement (P<.001) and lateral displacement (P<.001). Posteriorly, post hoc testing identified a significant reduction in the concussion group (pretest: 5.7±1.6cm; posttest: 2.6±2.1cm; P<.001), but no difference in the healthy student athlete group (pretest: 4.0±1.6cm; posttest: 4.0±2.5cm; P=.921). Laterally, post hoc testing identified a significant reduction in the concussion group (pretest: 5.8±2.1cm; posttest: 3.8±1.8cm; P<.001), but no difference in the healthy student athlete group (pretest: 5.0±2.5cm; posttest: 5.2±2.4cm; P=.485).

Conclusions: The results of this study suggest difficulty in the planning and execution of GI acutely postconcussion, and posterior APA displacement and velocity are highly effective measures of impaired postural control. Finally, the APA phase is linked to the supplementary motor area, which suggests a supraspinal contribution to postconcussion impaired postural control.

Citing Articles

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Increased Auditory Dual Task Cost During Gait Initiation in Adult Patients With Persistent Concussion Symptoms.

Bryk K, Passalugo S, Shan Chou L, Reisman D, Hafer J, Semrau J Arch Phys Med Rehabil. 2024; 105(12):2262-2268.

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An assessment of current concussion identification and diagnosis methods in sports settings: a systematic review.

Daly E, Pearce A, Finnegan E, Cooney C, McDonagh M, Scully G BMC Sports Sci Med Rehabil. 2022; 14(1):125.

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Murray N, Moran R, Islas A, Pavilionis P, Szekely B, Alphonsa S J Clin Transl Res. 2021; 7(4):443-449.

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