Objective To assess correlations in smartphone-measured single- and dual-task gait changes with sleep quality changes during recovery from concussion between two timepoints.

Design Prospective, cohort study.

Setting Sports medicine center at a regional children’s hospital.

Participants We enrolled twenty-seven individuals 12–18 years of age with concussion (15.41.6 years, 56% female).

Interventions Participants completed assessments ≤14 days of sustaining a concussion (7.33.1 days post-injury) and again 4 weeks later (27.83.4 days between assessments). At both assessments, participants rated sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and underwent a motor/cognitive evaluation. A smartphone affixed to the lumbar spine acquired and analyzed single- and dual-task spatiotemporal gait and cognitive metrics during a 20-meter self-paced walking task. For dual-task gait, participants additionally responded to a series of Stroop cognitive cues aloud.

Outcome Measures Primary outcomes included changes in single- and dual-task gait velocity (m/s), cognitive/Stroop accuracy (%), and PSQI score between assessments. Pearson correlation coefficients were used to determine the relationship between changes in motor-cognitive performance and sleep quality.

Main Results There was a low/significant correlation between sleep quality and gait, where improved sleep quality across time was associated with faster single-task (r=-0.41, p=0.04) and dual-task (r=-0.41, p=0.04) gait velocity across time. There was a moderate/significant correlation between sleep quality and dual-task accuracy, where sleep quality improvements were correlated with better dual-task cognitive accuracy changes (r=-0.54, p=0.02).

Conclusions In adolescents following concussion, PSQI score improvements were correlated with improvements in motor/cognitive performance, suggesting an area for targeted interventions during concussion recovery.