The influence of concussion history on turning gait performance

Eric J Shumski; Deborah A Barany; Julianne D Schmidt; Robert C Lynall

doi:10.1016/j.gaitpost.2025.04.026

The influence of concussion history on turning gait performance

Gait Posture. 2025 Apr 25:121:93-100. doi: 10.1016/j.gaitpost.2025.04.026. Online ahead of print.

Authors

Eric J Shumski¹, Deborah A Barany², Julianne D Schmidt³, Robert C Lynall³

Affiliations

¹ UGA Biomechanics Laboratory, Department of Kinesiology, University of Georgia, Athens, Georgia; UGA Concussion Research Center, Department of Kinesiology, University of Georgia, Athens, Georgia. Electronic address: ericshumski@gmail.com.
² UGA Brain and Action Laboratory, Department of Kinesiology, University of Georgia, Athens, Georgia; Department of Interdisciplinary Biomedical Sciences, School of Medicine, University of Georgia, Athens, Georgia.
³ UGA Biomechanics Laboratory, Department of Kinesiology, University of Georgia, Athens, Georgia; UGA Concussion Research Center, Department of Kinesiology, University of Georgia, Athens, Georgia.

PMID: 40339308
DOI: 10.1016/j.gaitpost.2025.04.026

Abstract

Objective: Straight path gait under dual-task conditions recovers ∼2 months post-concussion. However, turning gait is more complex than straight path gait and may take longer to recover, especially under dual-task conditions. Therefore, the purpose of this study was to compare how individuals with and without a concussion history may differ in (1) turning gait spatiotemporal characteristics during single- and dual-task (serial 7 s) conditions, (2) the dual-task cost on the spatiotemporal characteristics and cognitive outcomes, and (3) the subjectively perceived task demands of single- and dual-task turning gait.

Methods: Twenty-three individuals with (age: 20.2 ± 1.9 years, BMI: 22.9 ± 2.7 kg/m², 60.9 % female, 44.7months [95 % CI=23.6, 65.7] months post-concussion) and 23 individuals without (age: 20.7 ± 1.7years, BMI: 22.4 ± 2.3 kg/m², 60.9 % female) a concussion history participated. Participants completed 3 trials of single-task serial subtraction, single-task figure-of-8 gait, and dual-task figure-of-8 gait. After each walking condition, participants completed the NASA Task Load Index to measure task demands.

Results: There was no significant group by cognitive load interaction for turning gait metrics (p-range=0.371-0.889) or task demands (i.e., NASA Task Load Index) (p = 0.598). There was no difference between groups for dual-task cost cognitive or gait outcomes (p-range=0.227-0.937). All participants displayed slower gait velocity (p < 0.001, Hedge's g=1.149), greater double leg support percent (p < 0.001, Hedge's g= 0.649), and wider step width (p = 0.003, Hedge's g=0.644) during dual-task versus single-task figure-of-8 gait. Individuals with a concussion history displayed shorter step length compared to individuals without a concussion history (p = 0.014, Hedge's g=0.664). All participants reported significantly lower task demands during single-task versus dual-task gait conditions (p < 0.001, Hedge's g=1.532).

Conclusion: Those with a concussion history demonstrated moderately shorter step length, but the lack of any other significant findings limits clinical applicability. Greater perceived dual-task demands can be used to ensure more self-perceived challenges are being utilized during rehabilitation.

Keywords: Curved path gait; Fall risk; Mild traumatic brain injury; Musculoskeletal injury; Walking.