Evidence of a conservative gait strategy in athletes with a history of concussions.
Evidence of a conservative gait strategy in athletes with a history of concussions.
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DOI：
10.1016/j.jshs.2015.03.010
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发表时间：
2016-12
影响因子：
11.7
通讯作者：
Hall EE
中科院分区：
文献类型：
--
作者：
Buckley TA;Vallabhajosula S;Oldham JR;Munkasy BA;Evans KM;Krazeise DA;Ketcham CJ;Hall EE
3次或3次以上的脑震荡病史常伴有许多短期和长期的神经病变。姿势控制障碍是脑震荡的一个已知急性后果；然而，关于多次脑震荡对步态影响的证据有限。本研究的目的是评估基于脑震荡病史的大学年龄学生运动员的步态跨步特征。63名参与者根据脑震荡病史分为≥3次、1-2次和0次脑震荡3组。所有参与者都完成了10次在4.9米的仪器人行道上的步态试验。感兴趣的因变量包括步态步进特征（步速、长度和宽度、双支撑时间和步态周期在站立中的百分比）和变异性系数（CoV）测量（步长、时间和宽度）。首先采用单因素方差分析（MANOVA）与随访的单因素方差分析（single -way anova）和适当的Tukey事后检验（Tukey post hoc）对步态步进特征进行比较。冠状病毒测量值采用单因素方差分析和Tukey事后检验进行比较。对组的主要影响因素有台阶速度、台阶长度、台阶宽度和双支撑时间。总的来说，0脑震荡组表现出典型的健康年轻人的步态参数，表现明显优于任何一个脑震荡组。0震荡组的步长冠状病毒显著增加，但步长时间和宽度冠状病毒无显著差异。这一发现为先前有脑震荡病史的个体在步态中姿势控制的细微损伤提供了证据，这可能是未来神经缺陷的早期指标。变异性测量的有限差异与先前的静态姿势研究一致，可能表明个体限制其运动系统以减少变异性。综上所述，这些发现表明有脑震荡史的个体采用保守的步态策略。
A history of 3 or more concussions is frequently associated with numerous short- and long-term neuropathologies. Impairments in postural control are a known acute consequence of concussion; however, limited evidence exists on the effects of multiple concussions on gait. The purpose of this study was to assess gait stepping characteristics in collegiate aged student-athletes based on concussion history. There were 63 participants divided into 3 even groups based on concussion history: ≥3 concussions, 1–2 concussions, and 0 concussion. All participants completed 10 trials of gait on a 4.9 m instrumented walkway. The dependent variables of interest included both gait stepping characteristics (step velocity, length, and width, double support time, and the percentage of the gait cycle in stance) and coefficient of variability (CoV) measures (step length, time, and width). The gait stepping characteristics were compared first with a MANOVA with follow-up 1-way ANOVAs and Tukey post hoc tests as appropriate. The CoV measures were compared with 1-way ANOVAs and Tukey post hoc tests. There were main effects for group for step velocity, length, width, and double support time. Overall, the 0 concussion group displayed typical healthy young gait parameters and performed significantly better than either concussion group. The 0 concussion group had a significantly greater step length CoV, but there were no differences in the step time or width CoV. This finding provides evidence of subtle impairments in postural control during gait among individuals with prior history of concussion which could be an early indicator of future neurological deficiencies. The limited difference in the variability measures is consistent with prior static stance studies and could suggest the individuals constrain their motor systems to reduce variability. Taken together, these findings suggest a conservative gait strategy which is adopted by individuals with a history of concussions.
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