Presence of headache does not influence sideline neurostatus or balance in high school football athletes.

OBJECTIVE: Headache is the primary self-reported symptom used to indicate concussion. Thus, we examined the relationship between reports of nonconcussion-induced headache after contact sport participation and scores on common concussion assessment measures. DESIGN: Two-group repeated measures. SETTIN:: Secondary school. PARTICIPANTS: One hundred five athletes from 3 area football teams completed a baseline evaluation. Sixteen athletes reported headaches after a practice/game and were compared with 16 gender-matched, age-matched, height-matched, weight-matched, and position-matched controls. INDEPENDENT VARIABLE: Self-report headache. MAIN OUTCOME MEASURES: Symptom severity and endorsement reported on the Graded Symptoms Checklist (GSC), neurostatus measured using the Standard Assessment of Concussion (SAC), and postural control evaluated with the Balance Error Scoring System (BESS). RESULTS: Total symptom severity significantly increased (P < 0.01; 8.06 ± 2.22 to 16.06 ± 3.82) in the headache group and significantly decreased in the nonheadache group (P = 0.01; 6.81 ± 1.85 to 3.00 ± 1.08). Symptom endorsement increased in the headache group (P = 0.06; 3.25 ± 0.80 to 5.25 ± 1.08) and significantly decreased in the nonheadache group (P = 0.01; 3.19 ± 0.78 to 1.69 ± 0.58). Both groups showed nonsignificant (P > 0.05) changes in SAC scores (headache, 24.75 ± 0.73 to 24.81 ± 0.75; nonheadache, 24.50 ± 0.73 to 24.87 ± 1.20). Errors of the BESS significantly increased in both the groups at postgame/postpractice evaluation (headache, P = 0.01; 14.94 ± 1.86 to 20.31 ± 2.23; nonheadache, P < 0.01; 13.31 ± 1.68 to 18.13 ± 1.69). The presence of headache was significantly correlated with symptom reports (P > 0.05) but not SAC or BESS performance. CONCLUSIONS: These findings indicate that the use of headache, exclusively or in combination with other concussion-related symptoms, does not indicate performance on common concussion tools. This supports previous works, suggesting that clinicians must adopt a multifaceted approach to concussion assessment.

The chronic effects of concussion on gait.

OBJECTIVE: To examine the effects of concussion on gait patterns of young adults with and without a history of concussion during single- and dual-task paradigms. DESIGN: Cross-sectional evaluation. SETTING: A research laboratory. PARTICIPANTS: Persons with (n=28; mean, 6.32y postinjury) and without (n=40) a concussion history. INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: A battery of gait analyses during single- and dual-task conditions. Normalized velocity, step length, stride width, number correct from cognitive task, time in single-leg stance, and time in double-leg stance were the variables of interest. Gait was analyzed using an electronic walkway system, and the Brooks visuospatial cognitive task was used to index cognition. RESULTS: Data analyses using multiple 2-way repeated-measures analyses of variance and correlations indicated that participants with a history of concussion spent significantly more time in a double-leg stance and significantly decreased time in a single-leg stance and had slower gait velocity. There also was a significant negative correlation between number of concussions and time in single-leg stance and positive correlations between number of concussions and time in double-leg stance and double-stance percent. CONCLUSION: These findings suggest that persons with a history of concussion adopt a more conservative gait strategy.

Balance performance in male and female collegiate basketball athletes: influence of testing surface.

The Star Excursion Balance Test (SEBT) is a simple and cost-effective balance test. Information on SEBT performance in athletic populations and under varying testing surfaces is needed to fully elucidate the clinical and training utility of this task. The purpose of this study was to examine SEBT performance in division I, collegiate basketball athletes (men = 9, women = 7) and in a healthy nonathlete control group (men = 7, women = 9). Each participant performed the SEBT with their dominant and nondominant limbs on stable and unstable testing surfaces while reaching in the anterior, medial, and posterior directions. No significant differences resulted between the dominant and nondominant limbs (p > 0.05). Significant differences were found between the basketball and control groups in all directions (p < 0.01) and the average reach score (p < 0.01) with the control group reaching 6-7% farther than the basketball group. A significant main effect for gender (collapsed across group and limb) was present in the posterior direction (p = 0.02). The SEBT performance in the medial and posterior directions and the average score were significantly (p < 0.01) reduced during testing on the unstable surface. These results suggest that athletic status may be a factor to consider when interpreting SEBT reach performance. Future research should examine the influence of SEBT testing in other athletic populations. Further, use of an unstable surface provided a greater challenge to balance. Additional research may provide insight into the role of using an unstable surface with the SEBT as part of an injury risk assessment and its use in identifying limb differences between injured and uninjured limbs.