Concussion assessment during gait

Abstract

The acute signs and symptoms (SS) of a concussion can vary widely between individuals. Clinicians currently use a variety of measures to diagnosis and manage both physical and cognitive SS associated with concussion. Balance is typically assessed using quick sideline measures in sports; however, researchers have found through more thorough assessments of dynamic balance during gait that SS may persist beyond those detected through typical assessment techniques. An appropriate gait assessment of concussion must be adequately complex to distinguish persistent balance deficits, but not so complex that healthy individuals would be challenged to maintain balance. A steady-state gait assessment may indicate conservative gait adaptations but will seldom yield distinct signs of continued dysfunction following concussion. Obstacle avoidance tasks demonstrate conservative gait adaptations long after other SS have resolved. Concussion typically results in balance deficits in divided attention dual-task paradigms even after a return to normal daily activities. Refinements of gait paradigms to be more specific and clinically useful define future advances in concussion assessment during gait.