{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T19:19:37Z","timestamp":1790018377753,"version":"4.0.1"},"reference-count":54,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2020,11,5]],"date-time":"2020-11-05T00:00:00Z","timestamp":1604534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"This research was funded by a research contract between Boston Children\u2019s Hospital, Cincinnati Children\u2019s Hospital Medical Center, and ElMindA Ltd","award":["4U01AI778109"],"award-info":[{"award-number":["4U01AI778109"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Persistent gait alterations can occur after concussion and may underlie future musculoskeletal injury risk. We compared dual-task gait stability measures among adolescents who did\/did not sustain a subsequent injury post-concussion, and uninjured controls. Forty-seven athletes completed a dual-task gait evaluation. One year later, they reported sport-related injuries and sport participation volumes. There were three groups: concussion participants who sustained a sport-related injury (n = 8; age =15.4 \u00b1 3.5 years; 63% female), concussion participants who did not sustain a sport-related injury (n = 24; 14.0 \u00b1 2.6 years; 46% female), and controls (n = 15; 14.2 \u00b1 1.9 years; 53% female). Using cross-recurrence quantification, we quantified dual-task gait stability using diagonal line length, trapping time, percent determinism, and laminarity. The three groups reported similar levels of sports participation (11.8 \u00b1 5.8 vs. 8.6 \u00b1 4.4 vs. 10.9 \u00b1 4.3 hours\/week; p = 0.37). The concussion\/subsequent injury group walked slower (0.76 \u00b1 0.14 vs. 0.65 \u00b1 0.13 m\/s; p = 0.008) and demonstrated higher diagonal line length (0.67 \u00b1 0.08 vs. 0.58 \u00b1 0.05; p = 0.02) and trapping time (5.3 \u00b1 1.5 vs. 3.8 \u00b1 0.6; p = 0.006) than uninjured controls. Dual-task diagonal line length (hazard ratio =1.95, 95% CI = 1.05\u20133.60), trapping time (hazard ratio = 1.66, 95% CI = 1.09\u20132.52), and walking speed (hazard ratio = 0.01, 95% CI = 0.00\u20130.51) were associated with subsequent injury. Dual-task gait stability measures can identify altered movement that persists despite clinical concussion recovery and is associated with future injury risk.<\/jats:p>","DOI":"10.3390\/s20216297","type":"journal-article","created":{"date-parts":[[2020,11,5]],"date-time":"2020-11-05T09:04:34Z","timestamp":1604567074000},"page":"6297","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Dual-Task Gait Stability after Concussion and Subsequent Injury: An Exploratory Investigation"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2955-0191","authenticated-orcid":false,"given":"David R.","family":"Howell","sequence":"first","affiliation":[{"name":"Sports Medicine Center, Children\u2019s Hospital Colorado, Aurora, CO 80045, USA"},{"name":"Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO 80045, USA"},{"name":"The Micheli Center for Sports Injury Prevention, Waltham, MA 02453, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4002-6286","authenticated-orcid":false,"given":"Scott","family":"Bonnette","sequence":"additional","affiliation":[{"name":"The SPORT Center, Division of Sports Medicine, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, OH 45219, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3835-363X","authenticated-orcid":false,"given":"Jed A.","family":"Diekfuss","sequence":"additional","affiliation":[{"name":"The SPORT Center, Division of Sports Medicine, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, OH 45219, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6102-8224","authenticated-orcid":false,"given":"Dustin R.","family":"Grooms","sequence":"additional","affiliation":[{"name":"Ohio Musculoskeletal &amp; Neurological Institute, Ohio University, Grover Center, Athens, OH 45701, USA"},{"name":"Division of Physical Therapy, School of Rehabilitation and Communication Sciences, College of Health Sciences and Professions, Ohio University, Grover Center, Athens, OH 45701, USA"},{"name":"Division of Athletic Training, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Grover Center, Athens, OH 45701, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory D.","family":"Myer","sequence":"additional","affiliation":[{"name":"The Micheli Center for Sports Injury Prevention, Waltham, MA 02453, USA"},{"name":"The SPORT Center, Division of Sports Medicine, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, OH 45219, USA"},{"name":"Departments of Pediatrics and Orthopaedic Surgery, College of Medicine, University of Cincinnati, Cincinnati, OH 45219, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6834-6257","authenticated-orcid":false,"given":"Julie C.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Sports Medicine Center, Children\u2019s Hospital Colorado, Aurora, CO 80045, USA"},{"name":"Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO 80045, USA"},{"name":"Division of Pediatrics, University of Colorado School of Medicine, Aurora, CO 80045, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"William P.","family":"Meehan","sequence":"additional","affiliation":[{"name":"The Micheli Center for Sports Injury Prevention, Waltham, MA 02453, USA"},{"name":"Division of Sports Medicine, Boston Children\u2019s Hospital, Boston, MA 02115, USA"},{"name":"Departments of Pediatrics and Orthopaedic Surgery, Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,11,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1136\/bjsports-2019-100579","article-title":"Return to play and risk of repeat concussion in collegiate football players: Comparative analysis from the NCAA Concussion Study (1999\u20132001) and CARE Consortium (2014\u20132017)","volume":"54","author":"McCrea","year":"2019","journal-title":"Br. 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