Hanno - DT Concussion Study

The Effect of Divided Attention on Running Biomechanics in Recently Concussed Collegiate Athletes

Natalie S. Hanno¹, Robert C. Lynall², Thomas G. Bowman¹

¹University of Lynchburg

²University of Georgia

ABSTRACT

BACKGROUND: Recently concussed athletes are at an elevated risk of sustaining a lower extremity musculoskeletal injury after returning to play compared to matched healthy controls. Current neuropsychological tests and return to play protocols may not fully identify neurocognitive and motor deficits as suggested by gait deficits identified during walking dual task studies. The purpose of this study was to examine running biomechanics with and without the addition of a cognitive task in recently concussed athletes to determine if deficits remain after the athlete is asymptomatic, has returned to baseline in all common clinical tests, and has been cleared for full contact play. METHODS: We recruited 7 recently concussed collegiate athletes (CONC) and 7 matched healthy controls (HC) who completed two testing sessions: within 24-72 hours of full game clearance (S1) and 1 week post-clearance (S2). Gait biomechanics were analyzed under four conditions: (1) walking alone (single task, ST), (2) walking while simultaneously completing simple mental tasks (dual task, DT), (3) running ST, and (4) running DT. Participants completed a total of 8 walking trials, followed by a total of 8 running trials counterbalanced between single and dual task conditions. RunscribeTM wearable shoe sensors (Scribe Labs, Inc., Half Moon Bay, CA, USA) were utilized to assess walking and running gait biomechanics. Results were analyzed using 2x2 mixed model ANOVAs to evaluate changes in gait across group (CONC, HC) and time (S1, S2). RESULTS: No significant interaction was found between group (CONC, HC) and session (S1, S2) for contact time (ms), pace (min/km), power (W), shock (G), stride length (m), and step rate (steps/min) (P>.05). DISCUSSION: Recently concussed athletes did not significantly alter gait biomechanics compared to matched healthy controls; thus, at the time of return to play, these athletes may be fully recovered. Additional research with a larger sample size is warranted to continue studying gait deviations following concussive injury.

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Video 1. Walking Dual Task

In this trial, the participant walked for 15 seconds while spelling 5-letter words in reverse.

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Video 2. Walking Dual Task

In this trial, the participant walked for 15 seconds while counting backwards by 7s from a random 3 digit number.

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Video 3. Running Dual Task

In this trial, the participant ran for 30 seconds while spelling 5-letter words in reverse.

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Video 4. Running Dual Task

In this trial, the participant ran for 30 seconds while counting backwards by 7s from a random 3 digit number.

Figure 1. Running DT Pace

Represents the change in pace (min/km) during running dual task (DT) trials from S1 to S2 in recently concussed athletes compared to matched healthy controls

Figure 2. Running DT Power

Represents the change in power (W) during running dual task (DT) trials from S1 to S2 in recently concussed athletes compared to matched healthy controls

Figure 3. Running DT Stride Length

Represents the change in stride length (m) during running dual task (DT) trials from S1 to S2 in recently concussed athletes compared to matched healthy controls

Figure 4. Running DT Step Rate

Represents the change in step rate (steps/min) during running dual task (DT) trials from S1 to S2 in recently concussed athletes compared to matched healthy controls

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