摘要
Background：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.Methods：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 coefficien of variability（CoV） measures（step length,time,and width）.The gait stepping characteristics were compared firs with a MANOVA with follow-up 1-way ANOVAs and Tukey post hoc tests as appropriate.The Co V measures were compared with 1-way ANOVAs and Tukey post hoc tests.Results：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 significant y better than either concussion group.The 0 concussion group had a significant y greater step length Co V,but there were no differences in the step time or width Co V.Conclusion：This findin 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 findi gs suggest a conservative gait strategy which is adopted by individuals with a history of concussions.
背景:3次或3次以上的脑震荡史常与许多短期或长期神经病理相关。姿势控制障碍是目前已知的脑震荡导致的严重后果之一,而关于多重脑震荡对步态影响的研究较少。本研究旨在评价有脑震荡史的大学生运动员的步态特征。方法:将63名受试者根据脑震荡史分为3组:≥3次脑震荡史、1-2次脑震荡史、无脑震荡史。每个受试者在4.9 m的检测步道上完成10次步态实验。因变量包括步态特征(步速、步长、步宽、双脚支撑时间、步态周期百分比)及变异系数(步长、时间、步宽)。先用多元方差分析比较步态特征,进而跟进用单因素方差分析,并根据情况用图基事后检验法。用单因素方差分析和图基事后检验法比较变异系数。结果:分组的主要影响包括步速、步长、步宽、双脚支撑时间。总体而言,无脑震荡史组表现出健康年轻人典型的步态参数,并明显优于其他两组。其步长变异系数更佳,但步行时间或步宽的变异系数与其他组无显著差异。结论:这一发现为有脑震荡史的个体在步态测试时表现出细微姿势控制障碍提供了证据,可作为以后研究神经缺陷的早期指标。变异性测量的差异有限,这与前期静态姿势的研究结果一致,表明个体会限制其运动系统以减少变异性。总之,本研究证明有脑震荡史的个体应采取保守的步态策略。
基金
funded,in part,by an NIH/NINDS grant (1R15NS070744-01A1)
a Georgia Southern University Faculty Development grant
