A preliminary study of longitudinal differences in local dynamic stability between recently concussed and healthy athletes during single and dual-task gait

Concussed individuals commonly exhibit locomotor deficits during dual-task gait that can last substantially longer than clinical signs and symptoms. Previous studies have examined traditional stability measures, but nonlinear stability may offer further information about the health of the motor control system post-concussion. For up to one year post-concussion, this study longitudinally examined the local dynamic stability of five concussed athletes and four matched healthy controls during single- and dual-task gait. Local dynamic stability (LDS) was estimated using short-term, finite-time maximum Lyapunov exponents calculated from tri-axial accelerometers placed on the trunk and head. No main effects of group or task were found for LDS or stride time variability, but significant group*task interactions were apparent for trunk stability and stride time variability. Concussed individuals exhibited decreased trunk LDS and increased stride time variability during dual-task walking compared to matched controls despite similar single-task stability and variability. These preliminary results reinforce previous reports that concussions persistently affect dual-task processes even when single-tasks may be unaffected. Furthermore, the decreased local dynamic stability during dual-task gait indicates the concussed group attenuated local disturbances less than their healthy teammates. The decreased dynamic stability during dual-task activities was present after the athletes were cleared for competition and may be a contributing factor in the higher rates of musculoskeletal injuries in athletes post-concussion. (C) 2016 Elsevier Ltd. All rights reserved.