Recent work has identified deficits in dual-task gait balance control for up to 2 months following adolescent concussion, however how resumption of pre-injury physical activities affects recovery is unknown.
To examine how return to activity affects recovery from concussion on measures of symptom severity, cognition, and balance control during single-task and dual-task walking.
Nineteen adolescents with concussion who returned to pre-injury activity within 2 months following injury and 19 uninjured, matched controls completed symptom inventories, computerized cognitive testing, and single-task and dual-task gait analyses. Concussion participants were assessed at 5 time points: within 72 hours, one week, two weeks, one month, and two months post-injury. Control participants were assessed at the same time points as their matched concussion counterparts. Return-to-activity (RTA) day was documented as the post-injury day which physical activity participation was allowed. The effect of returning to physical activity was assessed by examining the percent change on each dependent variable across time prior to and directly after the RTA. Data were analyzed by two-way mixed effects ANOVAs.
Following the RTA day, concussion participants significantly increased their total center-of-mass medial/lateral displacement (p= .009, [eta]p 2= .175) and peak velocity (p= .048, [eta]p 2= .104) during dual-task walking, when compared to pre RTA data, while no changes for the concussion group or between groups were detected on measures of single-task walking, forward movement, or cognition.
Adolescents with concussion displayed increased center-of-mass medial/lateral displacement and velocity during dual-task walking following RTA, suggesting a regression of recovery in gait balance control. This study reinforces the need for a multi-faceted approach to concussion management and continued monitoring beyond the point of clinical recovery.