Dual-task gait differences in female and male adolescents following sport-related concussion

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 +/- 0.11 m vs. 1.26 +/- 0.11 m, p = 0.001; males: 1.14 +/- 0.14 m vs. 1.22 +/- 0.15 m, p = 0.04) and dual-task gait (females: 0.99 +/- 0.10 m vs. 1.10 +/- 0.11 m, p = 0.001; males: 1.00 +/- 0.13 m vs. 1.08 +/- 0.14 m, 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.