Better Test?

July 24, 2018

Research presented at the NATA Clinical Symposia and AT Expo gives preliminary support for using “walk and think” tests to assess readiness to return to play after a concussion. An article from HealthDay News reports that these tests may help with preventing re-injury among student-athletes.

“If we can determine that athletes have recovered this ability after concussion, they may be less likely to get re-injured,” David Howell, PhD, ATC, a Lead Researcher in the Sports Medicine Center at Children’s Hospital Colorado, said.

In their study, Dr. Howell and his research team recruited 41 student-athletes who had been treated for a concussion and returned to play. The return to play decision is usually made after assessments on balance, movement, vision, and thinking/reasoning ability are passed.

The participants in Dr. Howell’s study completed a “dual-task gait test.” This evaluation gauges whether individuals can think while they are walking. Some of the tasks include subtracting by sevens starting at 99, spelling a word backwards, and stating the months of the year in reverse order.

Traditionally used to gauge patients with progressive brain diseases, such as Alzheimer’s or Parkinson’s, dual-task gait tests are hypothesized to show recovery from a concussion. The study’s findings seemed to support the idea of scores reflecting potential cognitive damage.

“Athletic trainers are concerned about the safety of athletes and, along with coaches and parents, want to be sure these students are fully healthy before they return to play,” Dr. Howell said. “Our study is the first to test the theory that subsequent injury risk is related to motor function and/or attentional deficits, which can be measured using dual-task tests.”

What this means for athletic trainers is that athletes returning to play before they are fully recovered from a concussion may have a higher risk of re-injury. In the study, 15 of the 41 participants sustained another injury within a year of resuming activity. Of those, four were concussions, and the others were knee dislocations, hip sprains, and ankle sprains.

“This early research sheds light on the complexities of the recovering brain and suggests that dual-task gait may be a paradigm worth looking at to reduce the risk of injury before clearing an athlete to return to play,” Dr. Howell said. “The next step is to translate this research into something athletic trainers can easily use to assess athletes.”

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