Alterations to locomotor navigation in a complex environment at 7 and 30 days following a concussion in an elite athlete

Primary objective: To compare the locomotor capacity during (1) unobstructed walking and (2) the circumvention of fixed obstacles with and without a simultaneous visual task in an elite athlete before and after a sports-related concussion. Research design: Case report. Methods and procedures: Gait analysis and clinical neuropsychological measures were taken pre- and at 7 and 30 days post-injury in an 18 year old male junior hockey player. The task consisted of walking along an unobstructed or obstructed path with or without a visual interference task. Measurements included dual tasks costs, response errors, maximal gait speed and minimal clearance with the obstacle. Main outcome and results: Although the athlete was symptom-free and neuropsychological test results returned to baseline relatively quickly, he showed continued errors in the interference task, abnormally small obstacle clearance distances and decreased maximal gait speed up to 30 days after the concussion. Conclusions: Concussion can result in persistent planning and attention deficits in ecologically valid, complex environments. This report suggests that functional assessment within an ecological context could be an innovative way to evaluate concussed athletes before sending them back to play, even in the absence of medically related symptoms or abnormal neuropsychological test results.