Inertial Sensors Reveal Subtle Motor Deficits When Walking With Horizontal Head Turns After Concussion.
Peter C Fino, Jennifer Wilhelm, Lucy Parrington and 3 others
PMID 30045224WHAT IT FOUND
Wearable sensors showed athletes with sport-related concussion turned their heads more slowly while walking with side-to-side head turns, even when walking speed and head range looked normal.
The difference was not present at day 10.
Key findings
01Athletes with sport-related concussion turned their heads more slowly than healthy controls while walking with head turns at days 2 and 5, and this difference was not present at day 10.
02Within 48 hours, head-turning speed was the only tested measure that could tell athletes with concussion from healthy athletes; head range, walking speed, task accuracy and clinical balance errors did not.
03Larger increases in head-turning speed between days 2 and 10 were associated with greater total symptom severity at day 2, but not with neck pain.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Testing environments varied across participants, so visual conditions may have affected some athletes differently. The order of the walking, seated head-turn and walking head-turn tasks was fixed rather than randomized or counterbalanced, so familiarity with the task may have influenced condition comparisons. The study lacked medical history data on pre-existing vestibular or oculomotor problems, which could have affected the head-turning task. Participants were not excluded for neck pain or neck injury, and the neck pain rating scale may have lacked enough resolution to detect an association. Only measurements before return to play were analyzed, at days 2, 5 and 10, so the results do not cover later recovery or return-to-play effects. Not all participants completed every session; the concussion group had 21 participants at day 2, 20 at day 5 and 20 at day 10.
The easy way to misread this
Do not use head-turning speed alone to diagnose concussion. Head-turning speed separated athletes with concussion from controls, while head range, walking speed, task accuracy and clinical balance errors did not, and the study did not test whether this improves diagnosis or treatment.