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UBC Theses and Dissertations

Multiple concussions and dual task paradigms : reactive postural perturbation management Dierijck, Jillian Katrina


Sport-related concussion has received increasing concern and research in the last 20 years. Despite much research being done in the acute phase, chronic disturbances as a result of multiple concussions have received notably less attention. Moreover, these long-term difficulties as a result of multiple concussions have the capacity to influence the future of the athletes sporting career as well as their day-to-day functioning. Of particular interest is the impact of multiple concussions on balance. While studies of quiet stance balance are informative, they do not challenge the postural control system as contact sport game-play does. Therefore, the purpose of this study was to evaluate the influence of multiple previous concussions on the ability to manage external perturbations (analogous to pushes and tackles) under varying attentional demands. A group of contact-sport athletes who have never had a concussion (n=16) and a group of contact sport athletes who have been exposed to two or more concussions (n=16) were recruited. Participants completed a button press task, an arm reaching task with unexpected external perturbations, and both tasks simultaneously. A 2×2 mixed model ANOVA was used to assess for the main effects of task (single vs. dual) and concussion history (zero vs. two or more). Dependent variables included aspects of centre of pressure (COP; displacement and velocity), hand kinematics (displacement and velocity), and reaction time. Under dual-task conditions performance decreased on a number of variables including COP, hand kinematics, and reaction time. Moreover, the group with multiple previous concussions performed significantly worse, particularly in COP metrics compared to the group who have no concussion history. These findings indicate a history of concussion alters COP metrics (postural control). Furthermore, these findings highlight the potential use of this novel task (combining external perturbations and a secondary attention task) in concussion assessment and return-to-play decision making. Taken together, the current findings add crucial information to the impact of concussion on postural control. Given this information, interventions need to be designed and implemented to mitigate the chronic disturbances to balance (that could influence the future sporting career and day-to-day life) which may result from exposure to multiple concussions.

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