Department of Human Physiology, University of Oregon, Eugene, OR 97403, USA; Baylor University - Keller Army Community Hospital, Division 1 Sports Physical Therapy Fellowship, West Point, New York 10963, USA.
Department of Human Physiology, University of Oregon, Eugene, OR 97403, USA.
Clin Biomech (Bristol). 2020 Dec;80:105145. doi: 10.1016/j.clinbiomech.2020.105145. Epub 2020 Aug 14.
Concussion may result in acutely impaired dynamic balance control that can persist up to two months post injury. Such impairment has been detected using sophisticated whole body center of mass kinematic metrics derived from camera-based motion analysis under a dual-task paradigm. However, wearable sensor kinematics for describing gait imbalance is lacking.
This study employed a longitudinal design. Gait balance control of acutely concussed and healthy matched control participants was assessed at five post-injury time points (within 72 h of injury, at one week, two weeks, one month, and two months). Tri-axial accelerations and angular velocities were collected with a dual-task gait protocol using an inertial measurement unit placed over the fifth lumbar vertebra.
Eight consistent gait event specific peak accelerations and six peak angular velocities measured by the inertial measurement unit were examined. Peak yaw and roll angular velocities at heel strike and peak roll angular velocities during early single-support, distinguished healthy from concussed participants across the two month post-injury period, while peak vertical acceleration at the end of terminal stance peak medial-lateral acceleration to the right during loading response showed promise.
Utilization of peak accelerations and angular velocities collected from a single inertial measurement unit placed over the fifth lumbar vertebra in a divided attention paradigm may offer a clinically feasible method for detecting subtle changes in gait balance control in concussed individuals.
脑震荡可能导致急性的动态平衡控制受损，这种损伤可持续长达受伤后两个月。这种损伤可以通过基于摄像机的运动分析在双重任务范式下从复杂的整体质心运动学指标中检测到。然而，用于描述步态失衡的可穿戴传感器运动学仍然缺乏。
本研究采用纵向设计。在受伤后五个时间点（伤后 72 小时内、1 周、2 周、1 个月和 2 个月）评估急性脑震荡和健康匹配对照组参与者的步态平衡控制。使用惯性测量单元（放置在第五腰椎上）在双重任务步态协议中收集三轴加速度和角速度。
检查了惯性测量单元测量的 8 个一致的步态事件特定峰值加速度和 6 个峰值角速度。在受伤后两个月的时间里，跟骨触地时的俯仰和横滚角速度峰值以及单足支撑早期的峰值横滚角速度峰值能够区分健康参与者和脑震荡参与者，而在负荷反应期终末站立时的垂直加速度峰值和右侧向的中间向加速度峰值也显示出一定的潜力。
在分散注意力范式中使用从放置在第五腰椎上的单个惯性测量单元收集的峰值加速度和角速度，可能提供了一种用于检测脑震荡个体步态平衡控制细微变化的临床可行方法。
