Nicholas G Murray, Brian Szekely, Madison R Taylor, Kristen G Quigley, Joseph McCarley, Nora Constantino, Kumiko Hashida, Kaori Tamura
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All data were collected at preseason physicals (baseline) and within 7 days of injury for SRC. Each participant completed 3 conditions of TG in a pseudorandomized order: (1) ST, (2) DT with serial-7s (SS) subtractions, and (3) DT with APST. Outcomes of time-to-complete for TG and behavioral (eg, responses per second) for SS and APST were recorded for each trial.</p><p><strong>Results: </strong>ST Trials 2 (<i>P</i> = 0.03) and 3 (<i>P</i> = 0.01) were significantly different between controls and SRC. ST Trial 3 (<i>P</i> = 0.04) was significantly different between baseline and SRC. Average responses per second for APST were significantly different between- (<i>P</i> < 0.01) and within- (<i>P</i> = 0.01) group.</p><p><strong>Conclusion: </strong>The results suggest that ST is significantly slower after SRC. However, DT (both SS and APST) time-to-complete are also important variables when predicting the SRC diagnosis. It is advised that both ST and DT be administered when making clinical decisions regarding postural instability after SRC.</p><p><strong>Clinical relevance: </strong>The best ST TG time to complete gait is an important objective marker of concussion while DT paradigms, specifically SS and APST, are highly variable. DT may be more useful for clinical observable signs of SRC. 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引用次数: 0
摘要
背景：本研究评估了串联步态（TG）过程中的两种不同的双重任务（DT）条件：本研究评估了串联步态（TG）中两种不同的双任务（DT）条件，以预测运动相关脑震荡（SRC）的诊断：最佳（最快）单任务（ST）步态在不同组别（对照组 vs SRC；基线组 vs SRC）之间存在差异，听觉纯转换任务（APST）反应率是帮助预测 SRC 的最重要行为变量：研究设计：队列设计：研究方法共有 409 名全美大学体育协会 I 级学生运动员对照组和 21 名经队医诊断的 SRC 参与了研究。所有数据均在季前体检（基线）和 SRC 受伤后 7 天内收集。每位参与者按照伪随机顺序完成了 3 种 TG 条件：(1) ST、(2) 带有 7 秒连减（SS）的 DT 和 (3) 带有 APST 的 DT。每次试验都记录了 TG 的完成时间以及 SS 和 APST 的行为结果（如每秒的反应）：ST 试验 2（P = 0.03）和 3（P = 0.01）在对照组和 SRC 之间存在显著差异。ST 试验 3（P = 0.04）在基线和 SRC 之间存在明显差异。APST的平均每秒反应在组间（P < 0.01）和组内（P = 0.01）有显著差异：结果表明，SRC 后 ST 明显变慢。结论：结果表明，SRC 后 ST 明显变慢，但 DT（包括 SS 和 APST）完成时间也是预测 SRC 诊断的重要变量。建议在对 SRC 后的姿势不稳做出临床决策时，同时使用 ST 和 DT：最佳 ST TG 完成步态时间是脑震荡的一个重要客观指标，而 DT 范式，特别是 SS 和 APST，则存在很大的可变性。DT可能对临床观察到的SRC体征更有用。SS和APST都有其独特的作用，但APST的每秒反应率可用于临床决策。
Single-Task and Dual-Task Gait Performance After Sport-Related Concussion: A Machine Learning Statistical Approach.
Background: This study evaluated 2 different dual-task (DT) conditions during tandem gait (TG) to predict sport-related concussion (SRC) diagnosis.
Hypothesis: The best (fastest) single-task (ST) gait will differ between groups (controls vs SRC; baseline vs SRC), with auditory pure switching task (APST) response rate being the most important behavioral variable to aid prediction of SRC.
Study design: Cohort design.
Level of evidence: Level 3.
Methods: A total of 409 National Collegiate Athletic Association Division I student-athlete controls and 21 team-physician-diagnosed SRC participated. All data were collected at preseason physicals (baseline) and within 7 days of injury for SRC. Each participant completed 3 conditions of TG in a pseudorandomized order: (1) ST, (2) DT with serial-7s (SS) subtractions, and (3) DT with APST. Outcomes of time-to-complete for TG and behavioral (eg, responses per second) for SS and APST were recorded for each trial.
Results: ST Trials 2 (P = 0.03) and 3 (P = 0.01) were significantly different between controls and SRC. ST Trial 3 (P = 0.04) was significantly different between baseline and SRC. Average responses per second for APST were significantly different between- (P < 0.01) and within- (P = 0.01) group.
Conclusion: The results suggest that ST is significantly slower after SRC. However, DT (both SS and APST) time-to-complete are also important variables when predicting the SRC diagnosis. It is advised that both ST and DT be administered when making clinical decisions regarding postural instability after SRC.
Clinical relevance: The best ST TG time to complete gait is an important objective marker of concussion while DT paradigms, specifically SS and APST, are highly variable. DT may be more useful for clinical observable signs of SRC. Both SS and APST have unique usefulness, but APST response rate per second can be relied upon numerically for clinical decisions.
期刊介绍：
Sports Health: A Multidisciplinary Approach is an indispensable resource for all medical professionals involved in the training and care of the competitive or recreational athlete, including primary care physicians, orthopaedic surgeons, physical therapists, athletic trainers and other medical and health care professionals.
Published bimonthly, Sports Health is a collaborative publication from the American Orthopaedic Society for Sports Medicine (AOSSM), the American Medical Society for Sports Medicine (AMSSM), the National Athletic Trainers’ Association (NATA), and the Sports Physical Therapy Section (SPTS).
The journal publishes review articles, original research articles, case studies, images, short updates, legal briefs, editorials, and letters to the editor.
Topics include:
-Sports Injury and Treatment
-Care of the Athlete
-Athlete Rehabilitation
-Medical Issues in the Athlete
-Surgical Techniques in Sports Medicine
-Case Studies in Sports Medicine
-Images in Sports Medicine
-Legal Issues
-Pediatric Athletes
-General Sports Trauma
-Sports Psychology
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