Parker Tonya M, Osternig Louis R, Lee Heng-Ju, Donkelaar Paul van, Chou Li-Shan
Motion Analysis Laboratory, Department of Human Physiology, University of Oregon, Eugene, OR 97403, USA.
Clin Biomech (Bristol). 2005 May;20(4):389-95. doi: 10.1016/j.clinbiomech.2004.12.004. Epub 2005 Jan 28.
The need to identify functional impairment following a brain injury is critical to prevent re-injury during the period of recovery. While many neuropsychological tests have been developed to assess cognitive performance, relatively little information on gait and dynamic stability is available on motor task performance for young adults following concussion. This study was performed to investigate the effect of divided attention following concussion on various gait variables. It was hypothesized that, when compared to uninjured controls, concussed subjects would demonstrate deficits in maintenance of dynamic stability.
Ten subjects with Grade 2 concussion completed testing within 48 h of injury as well as 10 age-, height-, weight-, and activity-matched controls. The gait protocol consisted of level walking under two conditions: (1) undivided attention (single-task) and (2) while simultaneously completing simple mental tasks (dual-task). Whole-body motion data were collected using a six-camera motion analysis system. A 13-segment biomechanical model was used to compute whole body center of mass motion and velocity.
Walking with a concurrent cognitive task resulted in significant changes in gait and center of mass measurements for both groups. Concussed subjects were found to be able to conservatively adjust their whole body center of mass motion to maintain dynamic stability while walking without divided attention. However, while walking with divided attention, subjects with concussion demonstrated a significantly greater medio-lateral center of mass sway.
These data suggest that the ability to control and maintain stability in the frontal plane during walking is diminished under divided attention in individuals following a concussion.
识别脑损伤后的功能障碍对于预防康复期间的再次损伤至关重要。虽然已经开发了许多神经心理学测试来评估认知表现，但关于脑震荡后年轻成年人运动任务表现中的步态和动态稳定性的信息相对较少。本研究旨在调查脑震荡后注意力分散对各种步态变量的影响。研究假设，与未受伤的对照组相比，脑震荡患者在维持动态稳定性方面会表现出缺陷。
10名2级脑震荡患者在受伤后48小时内完成测试，以及10名年龄、身高、体重和活动相匹配的对照组。步态测试方案包括在两种条件下的平地行走：（1）注意力不分散（单任务）和（2）同时完成简单心理任务（双任务）。使用六相机运动分析系统收集全身运动数据。使用13节段生物力学模型计算全身质心运动和速度。
两组在同时进行认知任务时行走，步态和质心测量都有显著变化。发现脑震荡患者在注意力不分散行走时能够保守地调整其全身质心运动以维持动态稳定性。然而，在注意力分散行走时，脑震荡患者的质心在中外侧的摆动明显更大。
这些数据表明，脑震荡患者在注意力分散时，行走过程中控制和维持额面稳定性的能力会下降。
