Presence of Neck or Shoulder Pain Following Sport-Related Concussion Negatively Influences Recovery

Our objective was to examine the effect of current neck or shoulder pain on concussion outcomes. Variables included symptom resolution and return-to-sport time, symptom severity, amount of school missed, and sleep disturbances. Three hundred twelve patients (37% female; median age = 15.0 years; evaluated median = 9 days postinjury) reported experiencing current neck or shoulder pain at initial evaluation, and 268 did not (31% female; median age = 14.7 years; evaluated median = 8 days postinjury). Neck or shoulder pain was associated with longer symptom resolution time (β = 6.38, 95% confidence interval [CI] = 2.44, 10.31; P = .002), more severe symptoms (β = 7.06, 95% CI = 4.91, 9.21; P < .001), and greater odds of missing >5 days of school (adjusted odds ratio [aOR] = 1.89, 95% CI = 1.23, 2.93; P = .004), and postinjury sleep problems (aOR = 2.20, 95% CI = 1.51, 3.21; P < .001). Experiencing neck or shoulder pain during the initial postinjury clinical evaluation was associated with worsened clinical outcomes. Clinicians may consider referral to early rehabilitation following concussion among those who report neck or shoulder pain.

A Longitudinal Investigation of Symptom Recovery following Concussion in Youth Soccer

OBJECTIVE

To prospectively evaluate symptom outcomes after youth soccer-related concussion.

STUDY DESIGN

Using a prospective cohort design, we enrolled male and female competitive soccer players age 8-17 years into 3 groups: concussed (n = 23), matched control (n = 23), and orthopedic injury (n = 24). Postconcussive symptoms were monitored serially via both athlete and parent report at days 1-2, 4, 7, 10, 30, and 90.

RESULTS

Repeated-measures analyses revealed a significant time by group interaction (F [12, 402] = 19.91, P < .001). In the initial days postinjury, the concussed group reported greater symptoms than the comparison groups, with more symptoms reported by athletes on average than parents. By 10 days, concussed athletes did not differ from the matched controls by either rater's report, but they did differ from the orthopedic injury group by parent report. At 30 days, no differences were apparent among groups. At 30 days, 100% of concussed youth and 91% of parents rated symptoms as back to preinjury levels using reliable change indices. At 30 days, 86% of athletes had been cleared to return to full game play.

CONCLUSIONS

The natural clinical history of concussion symptoms in youth competitive soccer players was similar to that seen in older athletes, with resolution in days to a few weeks. Additional study will be required to investigate which factors best predict symptom outcomes for individual athletes and how symptom report relates to performance-based outcome measures and underlying neurophysiologic recovery.

Early physical activity and clinical outcomes following pediatric sport-related concussion

OBJECTIVE

The objective of the study was to evaluate the clinical outcomes among patients who did and did not report engaging in early physical activity (PA) following sport-related concussion.

METHODS

We evaluated pediatric patients seen within 21 days of concussion. The independent variable was early PA engagement (since the injury and before initial clinical evaluation). Dependent variables included demographics, injury details, medical history, Health and Behavior Inventory (HBI) score, and balance, vestibular, and oculomotor function tests.

RESULTS

We examined data from 575 pediatric patients: Sixty-nine (12%) reported engaging in early PA (mean age=14.3±2.4 years; 30% female). The no PA group (mean age=14.5±2.4 years; 35% female) had significantly longer symptom resolution times than the early PA group (median= 16 [interquartile range (IQR)=8-24] vs. 10.5 [IQR=4-17] days; p=0.02). When controlling for pre-existing headache history and time from injury-evaluation time, the early PA group demonstrated lower odds of reporting current headache (adjusted odds ratio=0.14; 95% CI=0.07, 0.26), and reported lower symptom frequency ratings than the no PA group (b=-5.58, 95% CI=-8.94, -2.22).

CONCLUSIONS

Patients who did not engage in early PA had longer symptom duration, greater odds of post-injury headache, and greater symptoms at initial clinical evaluation. We cannot determine if patients engaged in early PA due to the lower symptom burden and higher functioning at the time of assessment, or if early PA positively affected outcomes. However, as early PA was associated with better post-injury outcomes, clinicians may consider supervised and structured early PA programs as a method to improve clinical outcomes following concussion.

RELEVANCE FOR PATIENTS

Children and adolescents who were engaged in PA after concussion presented to a clinic with less severe symptoms and had symptoms that resolved sooner compared to those who did not engage in early PA after concussion.

No differences in tandem gait performance between male and female athletes acutely post-concussion

OBJECTIVES

To test whether 1) concussed athletes demonstrate slower tandem gait times compared to controls and 2) concussed female athletes display greater post-injury deficits than males.

DESIGN

Prospective longitudinal METHOD: Fifty concussed collegiate student-athletes (32% female, age=20.18±1.27 years) completed tandem gait tests during pre-season (Time 1) and acutely (<72hours) post-concussion (Time 2), and twenty-five controls (52% female, age=21.08±2.22 years) completed tandem gait at two time points, 1.96±0.46 days apart. Participants completed four single-task (ST) and dual-task (DT) trials. During DT trials, they simultaneously completed a cognitive assessment. The best ST and DT times were recorded, along with cognitive accuracy, and the change score between the two assessments was calculated. A positive change in tandem gait time was indicative of worsening performance. A 2×2 (group*sex) ANOVA was used to examine change between pre-injury and post-injury tests for ST/DT tandem gait time and DT cognitive accuracy.

RESULTS

The change in tandem gait time from Time 1 to Time 2 was significantly higher for the concussion group relative to controls during both ST (Concussion: 1.36±2.6 seconds, Controls: -1.16±0.8 seconds, p<0.001) and DT (Concussion: 1.70±3.8 seconds, Controls: -0.94±1.7 seconds, p=0.002) tandem gait. There were no interactions or main effects of sex for tandem gait time or cognitive accuracy.

CONCLUSIONS

There were no sex-specific differences in the change in tandem gait performance among concussed collegiate athletes or controls. However, all concussed participants, regardless of sex, performed significantly worse on tandem gait than male and female controls, who both improved between testing time points.

Continuing Play, Symptom Severity, and Symptom Duration After Concussion in Youth Athletes

OBJECTIVE

To determine whether continuing to play after a concussion is associated with higher symptom burden or prolonged symptom duration.

DESIGN

Patients who presented for care at a sport concussion clinic within the first 3 weeks of injury were asked whether they continued to play immediately after their injury.

SETTING

Sport concussion clinic within a regional tertiary care hospital.

MAIN OUTCOME MEASURES

Clinical outcomes including symptom severity, symptom duration, age, time from injury-clinical presentation, sex, sport type, previous concussion history, and whether or not they experienced loss of consciousness or amnesia at the time of injury were recorded. Univariable comparisons between those who did and did not report continuing play were conducted. Multivariable linear regression models were constructed to identify the independent association of continuing to play postinjury with symptom burden and symptom recovery time, while controlling for the effect of potential confounding variables.

RESULTS

A total of 516 patients were included in the study, assessed a mean of 12.1 ± 5.2 days postinjury (35% female, mean age = 14.5 ± 2.3 years). A total of 227 (44%) continued play after sustaining a concussion. Continuing to play postconcussion was independently associated with higher symptom severity during the initial clinical evaluation [β-coefficient = 6.144, 95% confidence interval (CI), 1.357-10.93], but not with symptom duration evaluation (β-coefficient = 1.794, 95% CI, -15.66 to 19.25).

CONCLUSION

Those who continued to play postconcussion presented with more severe symptoms after injury. Recognition of suspected concussion and removal from play on diagnosis confirmation may lead to better initial clinical outcomes after concussion among child and adolescent athletes.

Determining the utility of a smartphone-based gait evaluation for possible use in concussion management

Objectives: Our was objectives were to (1) assess the validity of a smartphone-based application to obtain spatiotemporal gait variables relative to an established movement monitoring system used previously to evaluate post-concussion gait, and (2) determine the test-retest reliability of gait variables obtained with a smartphone.Methods: Twenty healthy participants (n = 14 females, mean age = 22.2, SD = 2.1 years) were assessed at two time points, approximately two weeks apart. Two measurement systems (inertial sensor system, smartphone application) acquired and analyzed single-task and dual-task spatio-temporal gait variables simultaneously. Our primary outcome measures were average walking speed (m/s), cadence (steps/min), and stride length (m) measured by the inertial sensor system and smartphone application.Results: Correlations between the systems were high to very high (Pearson r = 0.77-0.98) at both time points, with the exception of dual-task stride length at time 2 (Pearson r = 0.55). Bland-Altman analysis for average gait speed and cadence indicated the average disagreement between systems was close to zero, suggesting little evidence for systematic bias between acquisition systems. Test-retest consistency measures using the smartphone revealed high to very high reliability for all measurements (ICC = 0.81-0.95).Conclusions: Our results indicate that sensors within a smartphone are capable of measuring spatio-temporal gait variables similar to a validated three-sensor inertial sensor system in single-task and dual-task conditions, and that data are reliable across a two-week time interval. A smartphone-based application might allow clinicians to objectively evaluate gait in the management of concussion with high ease-of-use and a relatively low financial burden.

Sleep Quality and Quality of Life Among Healthy High School Athletes

We examined the association between sleep quality and quality of life (QOL) among uninjured high school athletes. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and the Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Profile 25 questionnaire. One hundred ten athletes reported poor sleep quality (mean PSQI: 6.6 ± 2.0; mean age: 15.3 ± 1.1; 62% female); 162 athletes reported good sleep quality (mean PSQI: 2.3 ± 1.3; mean age: 15.1 ± 1.7; 33% female). After adjusting for sex and age, worse sleep quality was associated with higher physical function/mobility (β = 0.034; 95% confidence interval [CI] = 0.007-0.060; P = .01), anxiety (β= 0.391; 95% CI = 0.263-0.520; P < .001), depressive symptom (β = 0.456; 95% CI = 0.346-0.565; P < .001), fatigue (β = 0.537; 95% CI = 0.438-0.636; P < .001), pain interference (β = 0.247; 95% CI = 0.119-0.375; P < .001), and pain intensity (β = 0.103; 95% CI = 0.029-0.177; P = .006) ratings. Poor self-reported sleep quality among adolescent athletes was associated with worse QOL ratings. Clinicians should consider assessing sleep hygiene to provide guidance on issues pertaining to reduced QOL.

Are Adolescent Climbers Aware of the Most Common Youth Climbing Injury and Safe Training Practices?

Finger growth plate injuries are the most common youth climbing injuries. The purpose of our study was to understand youth awareness of the most common youth climbing injury and safe training practices. We surveyed climbers, ages eight to 18 years old, at the 2017 USA Climbing Sport and Speed Youth National Championships. A total of 267 climbers completed the survey (mean age = 14 ± 2.7 years; 52% male). The A2 pulley injury was reported as the most common youth climbing injury by the largest portion of participants, 36%. The second most commonly identified injury was at the growth plate of the finger, 15% of participants, which was reported as significantly less than the A2 pulley injury, p < 0.001. Six percent of climbers reported the correct safe age to start double dyno campus board training. Roughly 18% of athletes identified growth plate injuries exclusively as a stress fracture, whereas 29.2% of those climbers self-reported as informed about finger growth plate injuries, but only 7.4% of climbers who self-reported as uninformed answered this question correctly. Misperceptions about skeletally-immature climbing injuries are prevalent amongst youth climbers. Education on the prevalence of finger growth plate injuries and the scarcity of A2 pulley injuries in youth climbers can increase diagnostic accuracy, improve care, and reduce long-term complications.

Sport Specialization, Club Sport Participation, Quality of Life, and Injury History Among High School Athletes

CONTEXT

Many factors can affect the injury risk and quality of life among high school athletes. Early sport specialization and club sport participation may be components to consider when assessing the injury risk and quality of life.

OBJECTIVE

To investigate patient-reported quality-of-life and injury-history measures among adolescent athletes at different sport-specialization levels and to compare these measures between those who did and those who did not report participating in club sports.

DESIGN

Cross-sectional study.

SETTING

High school athletic facility.

PATIENTS OR OTHER PARTICIPANTS

High school student athletes 13 to 18 years of age were recruited and tested during their annual preseason athletic physical examinations.

MAIN OUTCOME MEASURE(S)

Our primary grouping variables were sport-specialization level (classified as low, moderate, or high) and club sport participation (organized sport outside of traditional school athletics). Our outcome variables were the Patient-Reported Outcome Measurement Information System Pediatric Profile-37 rating, Severity Measure for Depression-Child score, and injury history.

RESULTS

A total of 97 individuals participated (mean age = 15.2 ± 1.1 years; 38% female). Relatively similar proportions of individuals reported participating at each level of sport specialization (low = 34%, moderate = 40%, high = 26%). Forty-six (48%) participants stated they participated in club sports. No differences were evident in quality of life (P values = .15-.92 across domains), depression (P = .60), or injury history (P > .70) among the specialization groups. Those who described participating in club sports had a higher proportion of time-loss musculoskeletal injuries (63% versus 29%; P = .002) and of injuries requiring imaging, injection, a cast, a brace, or crutches (72% versus 46%; P = .013) than those who did not.

CONCLUSIONS

Although no injury-history differences were found among the sport-specialization groups, a higher proportion of club sport athletes than nonclub sport athletes reported a history of injury. Club sports are generally seen as more competitive, and the higher number of injuries seen in this setting could be related to a higher level of play among club sport athletes.

Female adolescents demonstrate greater oculomotor and vestibular dysfunction than male adolescents following concussion

OBJECTIVE

To examine differences between male and female adolescents on measures of balance, vestibular and oculomotor function within 3 weeks of concussion among a group of pediatric patients presenting to a sports medicine clinic.

DESIGN

Medical record review.

SETTING

Sports medicine clinic.

PARTICIPANTS

197 female (median age = 15.2 years) and 381 male (median age = 14.6 years) pediatric patients seen for a concussion, evaluated 9.3 ± 5.2 (mean ± SD) days post-concussion.

MAIN OUTCOME MEASURES

Patients completed Balance Error Scoring System (BESS), tandem gait, gaze stability, and near point of convergence (NPC) tests.

RESULTS

A higher proportion of female patients exhibited abnormal NPC (22% vs. 14%; p = 0.017), gaze stability (53% vs. 43%; p = 0.028), and tandem gait tests (20% vs. 13%; p = 0.026) compared to male patients. Multivariable analysis indicated an independent association between female sex and increased odds of abnormal NPC (adjusted odds ratio [aOR] = 1.79, 95% CI = 1.07-3.00), and tandem gait tests (aOR = 1.96, 95% CI = 1.12-3.41) following concussion.

CONCLUSIONS

Our results indicate that within the first three weeks of a concussion, female pediatric patients demonstrated increased odds of exhibiting abnormal near point of convergence, and tandem gait test performance compared to male patients.

The Role of Aerobic Exercise in Reducing Persistent Sport-related Concussion Symptoms

Aerobic exercise has received increasing attention in the scientific literature as a component of management for individuals who sustain a concussion. Because exercise training has been reported to reduce symptoms and improve function for those experiencing persistent postconcussion symptoms, it represents a potentially useful and clinically pragmatic rehabilitation technique. However, the specific exercise parameters that best facilitate recovery from concussion remain poorly defined and unclear. This review will provide a summary of the current understanding of the role of subsymptom exercise to improve outcomes after a concussion and will describe the exercise parameters that appear to be important. The latter will take into account the three pillars of exercise dose-frequency, duration, and intensity-to examine what is currently known. In addition, we identify important gaps in our knowledge of exercise as a treatment for those who develop persistent symptoms of concussion.

Tandem Gait Test-Retest Reliability Among Healthy Child and Adolescent Athletes

CONTEXT

The tandem gait test is a method for assessing dynamic postural control and part of the Sport Concussion Assessment Tool, versions 3 and 5. However, its reliability among child and adolescent athletes has yet to be established.

OBJECTIVE

To examine the test-retest reliability of the single-task and dual-task tandem gait test among healthy child and adolescent athletes.

DESIGN

Descriptive laboratory study.

SETTING

Sports injury-prevention center.

PATIENTS OR OTHER PARTICIPANTS

Uninjured and healthy athletes between the ages of 9 and 18 years.

INTERVENTION(S)

Tandem gait measures repeated 3 times across the period of approximately 1 month.

MAIN OUTCOME MEASURE(S)

Participants completed the tandem gait test under single-task and dual-task (ie, while simultaneously executing a cognitive task) conditions. Our primary outcome measure was completion time during the single-task and dual-task conditions. We also assessed cognitive accuracy and response rate while participants completed the dual-task tandem gait test.

RESULTS

Thirty-two child and adolescent athletes completed the study (mean age = 14.3 ± 2.4 years; females = 16). Single-task tandem gait times were similar across the 3 testing sessions (14.4 ± 4.8, 13.5 ± 4.2, and 13.8 ± 4.8 seconds; P = .45). Dual-task tandem gait times steadily improved across the test timeline (18.6 ± 6.9, 16.6 ± 4.5, and 15.8 ± 4.7 seconds; P = .02). Bivariate correlations indicated moderately high to high agreement from test 1 to test 2 (single-task r = .627; dual-task r = 0.655) and from test 2 to test 3 (single-task r = 0.852; dual-task r = 0.775). Both the single-task (intraclass correlation coefficient; ICC [3,1] = 0.86; 95% confidence interval [CI] = 0.73, 0.93) and dual-task (ICC [3,1] = 0.84; 95% CI = 0.69, 0.92) conditions demonstrated high reliability across testing sessions.

CONCLUSIONS

Tandem gait outcome measures demonstrated high test-retest reliability in both the single- and dual-task conditions. The overall reliability was within the acceptable range for clinical practice, but improvements across tests suggested a moderate practice effect. Tandem gait represents a reliable, dynamic, postural-control test that requires minimal space, cost, and time.

Postconcussion: Receded Near Point of Convergence is not Diagnostic of Convergence Insufficiency

PURPOSE

To determine the frequency of occurrence of receded near point of convergence (NPC) in patients with chronic concussion-related symptoms and in those with receded NPC to enumerate the frequency of convergence insufficiency and other oculomotor disorders.

DESIGN

Retrospective cross-sectional study.

METHODS

Clinic charts were retrospectively reviewed for the prior 3.5 years to identify all patients < 21 years old who were > 28 days postconcussion, had chronic concussion-related symptoms, had normal visual acuity, and had received a comprehensive sensorimotor examination. The frequency of receded NPC and oculomotor diagnoses were determined.

RESULTS

Of the 83 eligible patients, 74 (89%) had receded NPC. Of these, 70 (95%) had oculomotor disorders; 30 (41%) had disorders of accommodation only; 21 (28%) had convergence insufficiency and accommodation deficits; and 6 (8%) had convergence insufficiency only. Six (8%) had a convergence deficit other than convergence insufficiency (all with concurrent accommodative disorders); 4 (5%) had both a nonspecific vergence dysfunction and accommodation deficits; 2 (3%) had convergence excess only; and 1 (1%) had both convergence excess and accommodative deficits.

CONCLUSION

A receded NPC was present in the majority of young patients with chronic postconcussion symptoms. Associated with numerous underlying oculomotor dysfunctions, the clinical finding of a receded NPC is not synonymous with the diagnosis of convergence insufficiency. Because treatment options for the various oculomotor dysfunctions differ, it is prudent that these patients undergo a thorough examination of their vergence and accommodative systems so that an accurate diagnosis can be made and appropriate treatment prescribed.

Exercise in the first week following concussion among collegiate athletes: Preliminary findings

OBJECTIVES

Our purpose was to examine the association between exercise after concussion with symptom severity, postural control, and time to symptom-resolution.

DESIGN

Longitudinal cohort.

METHODS

Collegiate athletes (n = 72; age = 20.2 ± 1.3 years; 46% female) with concussion completed a symptom questionnaire at initial (0.6 ± 0.8 days post-injury) and follow-up (2.9 ± 1.4 days post-injury) evaluations, and a postural control assessment at follow-up. Participants were grouped into those who exercised in between the time of injury and the follow-up evaluation and those who did not. Decisions regarding post-concussion exercise were made by a sports medicine team consisting of a single team physician and athletic trainers.

RESULTS

Thirteen athletes were not included in the current study, resulting in an 85% response rate. Thirteen of the athletes who completed the study exercised between evaluations (18%). There was no symptom resolution time difference between groups (median = 13 [IQR = 7-18] days vs. 13 [7-23] days; p = 0.83). Symptom ratings were similar between groups at the acute post-injury assessment (median PCSS = 18.5 [7.5-26] vs. 17 [14-40]; p = 0.21), but a main effect of group after adjusting for time from injury to assessment indicated the exercise group reported lower symptom severity than the no exercise group across both assessments (p = 0.044). The dual-task gait speed of the exercise group was higher than the no exercise group (0.90 ± 0.15 vs. 0.78 ± 0.16 m/s; p = 0.02).

CONCLUSIONS

Athletes who were recommended aerobic exercise after concussion did not have worse outcomes than those who were not. Exercise within the first week after concussion does not appear to be associated with detrimental clinical outcomes.

The Test-Retest Reliability of a Clinically-Relevant Dual-Task Assessment in Healthy College Students

Purpose

The dual-task (DT) paradigm consists of concurrent administration of motor and cognitive tasks which may demonstrate improved measurement properties of the included tasks as compared to independent administration. Our study examined the test-retest reliability of a clinically-relevant DT assessment.

Methods

Our prospective cohort study included 60 (53.3% female) healthy, recreationally active college students (Age=20.5–1.34 years; Height=171.7–9.33 cm). Participants completed the Standardized Assessment of Concussion (SAC) and timed tandem gait (TTG) test concurrently for the DT assessment at two time points separated by a two-week test-retest interval. The SAC composite score (45 points) was calculated by summing the domain scores of immediate memory (30 points) which consisted of a 10-word list, concentration (5 points), and delayed recall (10 points). The TTG composite score was calculated by summing the mean time to complete the TTG during each SAC task (3 trials for immediate memory, up to 5 trials for the digits-backwards task, and one trial for the months in reverse order and delayed recall tasks). Mixed-model intraclass correlation coefficients (ICC[3,1]) with 95% confidence intervals were calculated to evaluate test-retest reliability between time points for the SAC and TTG composite scores.

Results

Mean SAC (39.4–3.80 vs. 39.6–3.49 points) and TTG (52.1–9.44 vs. 48.2–8.33 sec) composite scores were observed at time points 1 and 2, respectively. Moderate (ICC[3,1]=0.56 [0.26, 0.74]) and good (ICC[3,1]=0.88 [0.80, 0.93]) test-retest reliability were observed for the SAC and TTG composite scores, respectively.

Conclusion

Test-retest reliability for our DT assessment aligns with previously established values for independent administration of the SAC and TTG.

Concussed athletes walk slower than non-concussed athletes during cognitive-motor dual-task assessments but not during single-task assessments 2 months after sports concussion: a systematic review and meta-analysis using individual participant data

Objectives

To determine whether individuals who sustained a sports concussion would exhibit persistent impairments in gait and quiet standing compared to non-injured controls during a dual-task assessment .

Design

Systematic review and meta-analysis using individual participant data (IPD).

Data sources

The search strategy was applied across seven electronic bibliographic and grey literature databases: MEDLINE, EMBASE, CINAHL, SportDISCUS, PsycINFO, PsycARTICLES and Web of Science, from database inception until June 2017.

Eligibility criteria for study selection

Studies were included if; individuals with a sports concussion and non-injured controls were included as participants; a steady-state walking or static postural balance task was used as the primary motor task; dual-task performance was assessed with the addition of a secondary cognitive task; spatiotemporal, kinematic or kinetic outcome variables were reported, and; included studies comprised an observational study design with case–control matching.

Data extraction and synthesis

Our review is reported in line with the Preferred Reporting Items for Systematic review and Meta-Analyses-IPD Statement. We implemented the Risk of Bias Assessment tool for Non-randomised Studies to undertake an outcome-level risk of bias assessment using a domain-based tool. Study-level data were synthesised in one of three tiers depending on the availability and quality of data: (1) homogeneous IPD; (2) heterogeneous IPD and (3) aggregate data for inclusion in a descriptive synthesis. IPD were aggregated using a ‘one-stage’, random-effects model.

Results

26 studies were included. IPD were available for 20 included studies. Consistently high and unclear risk of bias was identified for selection, detection, attrition, and reporting biases across studies. Individuals with a recent sports concussion walked with slower average walking speed (χ2=51.7; df=4; p<0.001; mean difference=0.06 m/s; 95% CI: 0.004 to 0.11) and greater frontal plane centre of mass displacement (χ2=10.3; df=4; p=0.036; mean difference −0.0039 m; 95% CI: −0.0075 to −0.0004) than controls when evaluated using a dual-task assessment up to 2 months following concussion.

Summary/conclusions

Our IPD evidence synthesis identifies that, when evaluated using a dual-task assessment, individuals who had incurred a sports concussion exhibited impairments in gait that persisted beyond reported standard clinical recovery timelines of 7–10 days. Dual-task assessment (with motion capture) may be a useful clinical assessment to evaluate recovery after sports concussion.

Protocol pre-registration

This systematic review was prospectively registered in PROSPERO CRD42017064861.