Gait Initiation Alone May be Insufficient to Identify a Neuromuscular Mechanism Underlying Concussion-Related Kinematic Alterations

Authors

Tyler A. Wood, Northern Illinois UniversityFollow
Rafael Casas, University of MiamiFollow
Chris Hill, Northern Illinois UniversityFollow
Nicholas E. Grahovec, Northern Illinois UniversityFollow

Abstract

Purpose: Concussions create significant long-term health consequences, such as kinematic alterations, which may contribute to lower extremity musculoskeletal injury, dexterity limitations, disability, and declines in quality of life. A potential movement test that may identify neuromuscular mechanisms underlying these kinematic alterations is gait initiation. Gait initiation can assess preparatory postural adjustments as an individual transitions from static balance to voluntary movement. Thus, this study aims to examine muscle activation latency of individuals who sustained a concussion 3 to 24 months prior to testing, compared to healthy controls, during gait initiation tasks. Methods: This case-control study included 32 individuals who sustained a concussion 3 to 24 months prior to testing and 28 healthy controls who completed five trials of gait initiation. Participants were fitted with electromyography sensors on their right vastus medialis, semitendinosus, tibialis anterior, and medial gastrocnemius to identify a potential neuromuscular mechanism underlying kinematic alterations. A series of ANCOVAs were utilized to identify group differences in muscle activation latency of the vastus medialis, semitendinosus, tibialis anterior, and medial gastrocnemius; reaction time; preparatory center of pressure (COP) path length; preparatory COP velocity; initial step length; mini-mental state examination score; Montreal Cognitive Assessment score; concussion symptom score. Results: Data collected in the current study displayed no group differences in muscle activation latency of the vastus medialis, semitendinosus, tibialis anterior, and medial gastrocnemius, reaction time, preparatory COP path length, preparatory COP velocity, or initial step length (p>0,05). However, the data did reveal significant group differences to cogitative measures (mini-mental state examination score; Montreal Cognitive Assessment score) and concussion symptom score. Individuals who sustained a concussion displayed worse cognitive performance and greater concussion symptoms. Conclusion: Gait initiation tasks alone may not be challenging enough to elicit observable neuromuscular alterations following concussion. Future research should continue to identify diagnostic tests to identify the neuromuscular mechanism underlying concussion-related kinematic alterations to improve the quality of life of individuals who sustain a concussion.

Author Bio(s)

Tyler A. Wood, PhD, LAT, ATC, is an Assistant Professor and Coordinator of Clinical Education for the Athletic Training Program at Northern Illinois University in DeKalb, IL.

Rafael Casas, MSAT, LAT, ATC is an Assistant Athletic Trainer for Track and Field and Cross Country at the University of Miami in Miami, FL.

Nicholas E. Grahovec, PhD, LAT, ATC, CSCS, is an Assistant Professor and Program Director for the Athletic Training Program at Northern Illinois University in DeKalb, IL.

Chris Hill, PhD, is an Assistant Professor of Biomechanics and Neuromotor Control at Northern Illinois University in DeKalb, IL.

Recommended Citation

Wood TA, Casas R, Hill C, Grahovec NE. Gait Initiation Alone May be Insufficient to Identify a Neuromuscular Mechanism Underlying Concussion-Related Kinematic Alterations. The Internet Journal of Allied Health Sciences and Practice. 2024 Jun 26;22(3), Article 3.