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Jain D, Huber CM, Patton DA, McDonald CC, Wang L, Ayaz H, Master CL, Arbogast KB. Use of functional near-infrared spectroscopy to quantify neurophysiological deficits after repetitive head impacts in adolescent athletes. Sports Biomech 2023:1-15. [PMID: 37430440 PMCID: PMC10776807 DOI: 10.1080/14763141.2023.2229790] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/21/2023] [Indexed: 07/12/2023]
Abstract
There is concern that repetitive head impact exposure (RHIE) may lead to neurophysiological deficits in adolescents. Twelve high school varsity soccer players (5 female) completed the King-Devick (K-D) and complex tandem gait (CTG) assessments pre- and post-season while wearing a functional near-infrared spectroscopy (fNIRS) sensor. The average head impact load (AHIL) for each athlete-season was determined via a standardised protocol of video-verification of headband-based head impact sensor data. Linear mixed effect models were used to determine the effects of AHIL and task condition (3 K-D cards or 4 CTG conditions) on the change in mean prefrontal cortical activation measured by fNIRS, and performance on K-D and CTG, from pre- to post-season. Although there was no difference in the pre- to post-season change in K-D or CTG performance, greater AHIL was associated with greater cortical activation at post-season in comparison to pre-season during the most challenging conditions of K-D (p = 0.003) and CTG (p = 0.02), suggesting that greater RHIE necessitates increased cortical activation to complete the more challenging aspects of these assessments at the same level of performance. These results describe the effect of RHIE on neurofunction and suggest the need for further study of the time course of these effects.
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Affiliation(s)
- Divya Jain
- Department of Bioengineering, University of Pennsylvania, PA, USA
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Colin M. Huber
- Department of Bioengineering, University of Pennsylvania, PA, USA
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Declan A. Patton
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Catherine C. McDonald
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Lei Wang
- College of Computing and Informatics, Drexel University, Philadelphia, PA, USA
- Data Science and Biostatistics Unit, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Hasan Ayaz
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
- Data Science and Biostatistics Unit, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA, USA
- Department of Psychology, College of Arts and Sciences, Drexel University, Philadelphia, PA
| | - Christina L. Master
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Drexel Solutions Institute, Drexel University, Philadelphia, PA
| | - Kristy B. Arbogast
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Lowe L, Castillo F, Allen M, Israel M, Yates C. Spatiotemporal Parameters of Gait Among Adolescent Athletes with Concussion When Performing a Visuospatial Cognitive Task. Int J Sports Phys Ther 2023; 18:338-347. [PMID: 37020449 PMCID: PMC10069392 DOI: 10.26603/001c.71361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 01/15/2023] [Indexed: 04/03/2023] Open
Abstract
Background Adolescent athletes aged 10 to 19 years are at the highest risk of experiencing sport-related concussions (SRCs). Despite the known deficits and battery of assessments following concussion, postural stability during dual-task gait remains understudied in this population. Purpose The purpose of this study was to evaluate the dual-task cost (DTC) in adolescents with an acute or chronic SRC compared to reference values from healthy athlete peers for spatiotemporal parameters of gait during walking with and without a concurrent visuospatial memory task presented on a hand-held tablet. Researchers hypothesized that adolescents during the acute phase of concussion would be likely to experience a greater DTC compared to healthy peers in at least one spatiotemporal parameter of gait when walking within the dual-task paradigm. Study Design Cross-sectional, observational cohort design. Methods Adolescents with concussion were recruited to participate. Subjects were divided into acute and chronic categories based on significant differences in the neuropsychological function after a period of 28 days. They walked at a self-selected speed along the 5.186-meter GAITRite® Walkway System with and without a concurrent visuospatial cognitive task presented on a hand-held tablet. Outcomes included normalized velocity (m/s), step length (m), and double limb (DLS) and single limb support (SLS) (defined as the percent of a gait cycle [%GC]). The data were then compared to the previously published reference values established using the same methods in the healthy athlete participants for all spatiotemporal parameters of gait. Results Data was collected on 29 adolescent athletes with SRC. Among males (15.53+/-1.12 years) with SRC, 20% of acute and 10% of chronic cases experienced a greater DTC compared to healthy athlete reference values. A similarly increased DTC was experienced by 83% of acute and 29% of chronic SRC cases for females (15.58+/-1.16 years). Conclusions Adolescent athletes with concussion may continue demonstrating deficits in gait capabilities even in the chronic phase, and compensatory gait strategies were not the same between males and females. Dual-task cost assessment using the GAITRite® may be a valuable adjunct to comprehensive analysis of gait following SRC. Level of Evidence 2.
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Affiliation(s)
- Leah Lowe
- Physical Therapy University of Central Arkansas
| | | | | | - Michael Israel
- Orthopedics, Pediatrics Arkansas Children's Hospital, University of Arkansas for Medical Sciences
| | - Charlotte Yates
- Physical Therapy University of Central Arkansas, University of Arkansas for Medical Sciences
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