Head stabilization patterns reflect long-term postural stability alterations during gait associated with history of concussion

Clinical gait testing following concussion is graded on overall performance rather than the neurological mechanisms contributing to postural control, including those designed to maintain stabilization of the head during movement. The objective of this study was to examine the influences of concussion history on the ability to stabilize the head during gait beyond clinical recovery. Sixteen healthy adults with a history of diagnosed concussion(s) and sixteen controls reporting no history of concussion were recruited for participation. Spatiotemporal metrics and triaxial accelerations at the levels of the head, neck, and lower trunk were collected during preferred and tandem gait across a six-meter path. Attenuation values between the trunk, neck, and head were calculated to assess the ability to reduce the magnitude of acceleration patterns as they ascended the spinal column during gait. Those with a history of concussion displayed greater mediolateral head accelerations compared to controls during both preferred and tandem gait despite no significant differences in spatiotemporal metrics. Individuals with concussion history also demonstrated decreased attenuation between the neck and head, suggesting an altered ability to mitigate ascending oscillations from the trunk. The overall results of this study indicate that concussion can negatively influence postural control during gait beyond the point of symptom cessation as determined by current clinical practices. The ability to stabilize the head during gait may be a valuable metric when assessing sensorimotor integration beyond the acute phase of onset concussion.