PTOtherArchives of physical medicine and rehabilitation2020

Differential Effects of Acute and Multiple Concussions on Gait Initiation Performance.

Thomas A Buckley, Barry A Munkasy, David A Krazeise and 3 others

PMID 32343972

WHAT IT FOUND

Athletes with three or more prior concussions showed reduced gait initiation displacement and velocity compared to healthy controls, despite passing standard clinical concussion tests.

This suggests subtle postural control deficits persist after multiple concussions, though the clinical impact is unknown.

Key findings

01Participants with ≥3 prior concussions had significantly reduced center of pressure displacement and velocity during gait initiation compared to those with no prior concussions.

02Standard clinical assessments (BESS, SAC, symptom checklist) showed no significant differences between the ≥3 prior concussions group and the healthy control group.

03Gait initiation deficits were most severe in the acute concussion group, moderate in the ≥3 prior concussions group, and absent in controls, indicating a continuum of impairment.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

Cross-sectional design cannot determine if the deficits are permanent, progressive, or transient. Concussion history relied on self-report, which may be inaccurate due to underreporting. The study only included young, high-functioning NCAA Division I athletes, so results may not generalize to other populations or older adults. Most participants in the ≥3 prior concussions group had exactly 3 or 4 concussions, limiting understanding of dose-response effects for higher numbers. The clinical significance of these subtle instrumented deficits is unknown. No motion capture or electromyography was used, limiting biomechanical detail.

Declared interests

Research Support, N.I.H., Extramural

The easy way to misread this

Do not assume that a normal score on standard clinical concussion tests (like the BESS) means an athlete with multiple prior concussions has no postural control deficits. This study shows that instrumented gait analysis can detect subtle impairments that these clinical tests miss.

Read it on PubMed →