Functional Movement Deficits In Relation to Sport-Related Concussion

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  • March 20, 2019
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  • Lynall, Robert
    • Affiliation: School of Medicine, Department of Allied Health Sciences, Curriculum in Human Movement Science
Abstract
  • The objective of this dissertation was to identify tandem gait dynamic balance deficits and assess dynamic functional movement in recreational athletes with and without a history of concussion within the past 18 months. We recruited a convenience sample of 30 college-aged recreational athletes. There were two groups (15 participants per group): 1) Recent concussion group (median time since concussion 126 days, range 28-432 days), and 2) Matched control group with no recent concussions. Control participants were matched to injured participants based on sex, age (±1 year), mass (±10%), and height (±5%). We measured center of pressure outcomes under 4 tandem gait (heel-to-toe walking) conditions: 1) Tandem gait (eyes open, no cognitive distraction), 2) Tandem gait, eyes closed (no cognitive distraction), 3) Tandem gait, eyes open, cognitive distraction (Brooks Visuospatial Task), and 4) Tandem gait, eyes closed, cognitive distraction (Brooks Visuospatial Task). We investigated joint kinematics and reaction time during 3 movement tasks: 1) Jump-landing, 2) Anticipated-cut, and 3) Unanticipated-cut. The recently concussed group demonstrated slower velocity during tandem gait compared to the control group (4.0 cm/s difference; F1,27=4.26; p=0.049; ES=0.38). Greater dual-task cost was observed for center of pressure speed (F3,26=5.13; p=0.032) such that the concussion group (23.5%) reduced their center of pressure speed to a greater extent than the control group (16.3%) during the eyes closed dual-task condition as compared to the eyes closed, no cognitive task condition. There were no between-group differences in reaction time during cutting tasks, but the control group displayed better reaction time cost (-10.7%) than the concussed group (-0.8%) during anticipated cutting (F2, 25=5.26; p=0.030). The concussed group displayed greater trunk flexion compared to the control group during anticipated cut towards the non-dominant side (5.1° difference; F2, 27=5.89; p=0.022; ES=0.63). There may be subtle movement differences that are detectable more than a month after return-to-activity following concussion, but the clinical meaning of these findings is unclear. Limitations include a lack of baseline data and a relatively small sample size. Longitudinal investigations should identify acute movement deficits after concussion in comparison with recovery on traditional concussion assessment tools while also recording musculoskeletal injury outcomes.
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  • In Copyright
Advisor
  • Blackburn, J. Troy
  • Mihalik, Jason
  • Plummer, Prudence
  • Guskiewicz, Kevin M.
  • Marshall, Stephen
Degree
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2016
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