Altered balance control following concussion is better detected with an attention test during gait

The purpose of this study was to examine the effects of concussion on gait stability when either a cognitive or motor perturbation is imposed. Fourteen individuals suffering from a grade II concussion and 14 matched controls performed a single task of level walking, a continuous sequential question and answer task while walking, and an obstacle-crossing task. Common gait spatial/temporal measurements, whole-body center of mass motion, and center of pressure trajectory were assessed. Concussed individuals adopted a more conservative strategy to maintain gait stability. Some measurements indicating conservative gait were seen during obstacle crossing, but this was most evident during the Q&A task. Concussed individuals also displayed signs of possible instability during the Q&A task. The question and answer task was most sensitive to distinguishing concussed individuals from healthy individuals, supporting the use of a similar dual-task modality in future testing after concussion to determine a proper time for return to activity.