Howell David R, Stracciolini Andrea, Geminiani Ellen, Meehan William P
The Micheli Center for Sports Injury Prevention, Waltham, MA, United States; Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, Boston, MA, United States; Brain Injury Center, Boston Children's Hospital, Boston, MA, United States.
The Micheli Center for Sports Injury Prevention, Waltham, MA, United States; Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, Boston, MA, United States; Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, United States.
Gait Posture. 2017 May;54:284-289. doi: 10.1016/j.gaitpost.2017.03.034. Epub 2017 Apr 1.
Concussion may affect females and males differentially. Identification of gender-related differences after concussion, therefore, may help clinicians with individualized evaluations. We examined potential differences in dual-task gait between females and males after concussion. Thirty-five participants diagnosed with a concussion (49% female, mean age=15.0±2.1 years, 7.5±3.0 days post-injury) and 51 controls (51% female, mean age=14.4±2.1 years) completed a symptom inventory and single/dual-task gait assessment. The primary outcome variable, the dual-task cost, was calculated as the percent change between single-task and dual-task conditions to account for individual differences in spatio-temporal gait variables. No significant differences in symptom severity measured by the post-concussion symptom scale were observed between females (32.0±18.0) and males (27.8±18.2). Compared with males, adolescent females walked with significantly decreased cadence dual-task costs after concussion (-19.7%±10.0% vs. -11.3%±9.2%, p=0.007) when adjusted for age, height, and prior concussion history. No significant differences were found between female and male control groups on other dual-task cost gait measures. Females and males with concussion also walked with significantly shorter stride lengths than controls during single-task (females: 1.13±0.11m vs. 1.26±0.11m, p=0.001; males: 1.14±0.14m vs. 1.22±0.15m, p=0.04) and dual-task gait (females: 0.99±0.10m vs. 1.10±0.11m, p=0.001; males: 1.00±0.13m vs. 1.08±0.14m, p=0.04). Females demonstrated a significantly greater amount of cadence change between single-task and dual-task gait than males after a sport-related concussion. Thus, differential alterations may exist during gait among those with a concussion; gender may be one prominent factor affecting dual-task gait.
脑震荡对女性和男性的影响可能存在差异。因此,识别脑震荡后与性别相关的差异,可能有助于临床医生进行个体化评估。我们研究了脑震荡后女性和男性在双任务步态方面的潜在差异。35名被诊断为脑震荡的参与者(49%为女性,平均年龄=15.0±2.1岁,受伤后7.5±3.0天)和51名对照组(51%为女性,平均年龄=14.4±2.1岁)完成了症状清单和单/双任务步态评估。主要结局变量双任务成本,计算为单任务和双任务条件之间的百分比变化,以考虑时空步态变量的个体差异。在脑震荡后症状量表测量的症状严重程度方面,女性(32.0±18.0)和男性(27.8±18.2)之间未观察到显著差异。在根据年龄、身高和既往脑震荡病史进行调整后,与男性相比,青少年女性在脑震荡后的双任务步态中步频下降幅度显著更大(-19.7%±10.0%对-11.3%±9.2%,p=0.007)。在其他双任务成本步态测量方面,女性和男性对照组之间未发现显著差异。脑震荡的女性和男性在单任务(女性:1.13±0.11米对1.26±0.11米,p=0.001;男性:1.14±0.14米对1.22±0.15米,p=0.04)和双任务步态(女性:0.99±0.10米对1.10±0.11米,p=0.001;男性:1.00±0.13米对1.08±0.14米,p=0.04)中的步幅也明显比对照组短。与运动相关的脑震荡后,女性在单任务和双任务步态之间的步频变化量明显大于男性。因此,脑震荡患者在步态过程中可能存在不同的改变;性别可能是影响双任务步态的一个突出因素。