Reliability and practical clinical application of an accelerometer-based dual-task gait balance control assessment.

BACKGROUND

Gait balance control assessment using whole body center of mass (COM) kinematic measures in concussed individuals reveals persistent balance deficits up to two months post-injury. A reliable and clinically practical gait balance control assessment leveraging similar kinematic measures is necessary to improve concussion assessment and management.

RESEARCH QUESTION: Can peak accelerations collected during a dual-task (DT) gait assessment from a single low back placed accelerometer be measured reliably on different days, by different raters, in different environments, and be practically applied in a Division One (D1) athletics program?

METHODS

A single accelerometer placed on the low back over the L5 vertebra was utilized with a DT gait analysis protocol. Twenty (10 F) healthy participants performed the assessment in a laboratory and non-laboratory environment, on two separate days, and with two different raters. Eight gait event specific peak accelerations along three orthogonal axes were collected. In addition, data were collected from a cohort of 14 D1 female soccer players during a single assessment to explore the practical clinical application.

RESULTS

Cronbach's α values for the eight metrics ranged from 0.881 to 0.980 and ICC values from 0.868 to 0.987. Average assessment time for the 14 D1 female athletes was 8.50 ± 0.58 min, and significant differences between walking conditions were identified for Vert Accel 1 (p < .01), Vert Accel 2 (p = .01), and A-P Accel (p < .01).

SIGNIFICANCE: High Cronbach's α and ICC values coupled with a short assessment time and sensitivity to differences in gait balance control indicate our testing apparatus and protocol are both reliable and clinically practical. Additionally, gait event specific peak accelerations from a single accelerometer can detect subtle changes in gait balance control and may facilitate improvements in sport-related concussion diagnosis and return to activity decision making.