Citation

Howell DR, Oldham J, Lanois C, Koerte I, Lin AP, Berkstresser B, Wang F, Meehan WP. Med. Sci. Sports Exerc. 2020; ePub(ePub): ePub.

Affiliation

Departments of Pediatrics and Orthopaedic Surgery, Harvard Medical School, MA.

Copyright

(Copyright © 2020, Lippincott Williams and Wilkins)

DOI

10.1249/MSS.0000000000002225

PMID

31985574

Abstract

PURPOSE: Few studies have investigated recovery between sexes using objective outcome measures. Our purpose was to examine the independent association between biological sex and recovery of post-concussion gait among collegiate athletes.

METHODS: We evaluated participants with a diagnosed concussion <7 days post-injury, and approximately 1.5 months and 3.5 months post-injury. Participants completed a single/dual-task gait evaluation and symptom inventory. During dual-task trials, they completed a mental task (backwards subtraction, spelling, or month recitation). The primary outcome measure was height-adjusted gait velocity recovery, defined as achieving normal gait velocity using established values: >0.56 and >0.50 gait velocity (m·s)/height (m) under single and dual-task conditions, respectively. We used a multivariable Cox proportional hazard model to identify associations between sex and dual-task recovery, controlling for age, concussion history, symptom severity, and loss of consciousness at the time of injury.

RESULTS: Ninety-four individuals participated in the study: 47 (50%) were female athletes (mean age=20.1, SD=1.3 years) and 47 (50%) were male athletes (mean age=20.3, SD=1.3 years). Sex was not independently associated with height-adjusted single-task gait velocity recovery after controlling for potential confounders (hazard ratio=1.62, 95% confidence interval=0.87, 3.01). However, male sex was independently associated with longer dual-task gait recovery time after controlling for potential confounders (hazard ratio=2.43, 95% confidence interval=1.11, 5.35).

CONCLUSION: Male athletes required a longer duration of time after concussion to achieve dual-task gait recovery than female athletes. Thus, functional dual-task abilities after concussion may be affected differentially by sex, and should be accounted for within individualized concussion management strategies.

Language: en