Date of Award

Spring 2021

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Rehabilitation Sciences

Program/Concentration

Kinesiology and Rehabilitation

Committee Director

Eric Schussler

Committee Member

Steven Morrison

Committee Member

Anastasia Raymer

Committee Member

Daniel Russell

Abstract

Concussion is the most common form of traumatic brain injury (TBI). However, there is a disproportionate level of understanding between the acute and chronic impairments associated with traumatic brain injury. Specifically, problems maintaining balance during standing and walking are cardinal signs of acute concussion, but the temporal extent to which postural control deficits remain following the initial injury are not well defined or understood. The purpose of the projects composing this dissertation was to examine the long-term effects of a prior history of concussion on static (i.e. standing) and dynamic (i.e. gait) postural control. To address this, healthy adults aged 18-45 reporting a prior history of concussion(s) as well as age-matched controls with no documented concussion history were recruited to participate. Static postural control was assessed using a force plate system to track each participant’s center-of-pressure during standing. Spatiotemporal parameters as well as head stability during gait were assessed using a pressure-sensitive walkway and accelerometers placed at the head, neck, and lower trunk, respectively. The findings of these projects indicate that concussion has detrimental effects on both static and dynamic postural stability years after the initial injury and clinical determination of recovery. Specifically, individuals with a prior history of concussion demonstrated greater postural sway displacement and reduced sway regularity under dual-task conditions compared to the control group. In addition, previously concussed individuals demonstrated less variability in their gait cadence and step length, which suggests a reduction in the complexity of the neural networks contributing to postural control. Lastly, individuals with a history of concussion demonstrated greater triaxial accelerations at the head during gait, indicating a reduced ability to attenuate gait-related oscillations and stabilize the head. Collectively, these findings indicate that concussion is associated with impaired postural control that persists for years after the initial injury and well beyond the point where clinical testing protocols can identify deficits in maintaining balance. Future efforts should be directed toward incorporating more sophisticated measures and analyses of postural stability in concussion screenings to improve clinicians’ abilities to identify the scope in which concussion negatively impacts the function of the central nervous system.

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DOI

10.25777/71r7-5774

ISBN

9798515245924

ORCID

0000-0001-6052-324X

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