Sleep disturbances from stress are common among college students. In addition, student-athletes in contact sports (e.g., football and soccer) are at a higher risk of receiving a mild traumatic brain injury(mTBI). Stress-related sleep disturbances and mTBI may provoke cognitive and brain changes associated with gait abnormalities. Therefore, the purpose of this study was to examine the association between stress, sleep disturbances, mTBI, and gait performance among college student-athletes. Twelve college student-athletes from men’s and women’s soccer teams who indicated a history of mTBI (experimental group) and twenty-eight college students without a history of mTBI (control group) were recruited and asked to perform gait analysis with an in-shoe pressure measurement system during and after the midterm exam. Cadence, step time, stride time, stance time, and swing time were measured. Meanwhile, 14-days consecutive wrist actigraphy data and survey data from two sets of questionnaires were collected to assess their stress, sleep, and fatigue.

The mTBI group had significantly less step time (0.55±0.04 vs. 0.58±0.06 s, p=.011) and stance time (0.65±0.02 vs. 0.70±0.05 s, p=.013) compared to the control group during the exam week. The control group had significantly greater step time and stance time during the midterm exam than after the midterm exam. However, no significant differences in other gait parameters were observed for the mTBI group during and after the midterm exam.

The stress level was positively associated with sleep disturbances, poor daytime functioning, and poor activity correlation. Moreover, stress during midterm exam week increased the activity MESOR in both the control group and the TBI group. However, the effect of stress on the TBI group sleep parameters was higher than the control group.

The outcome of this study was able to facilitate a faster and more accurate diagnosis of concussion with the understanding of mTBI-related lower body gait changes. Moreover, it was an innovative approach to decouple the long-term effect of sleep disturbances on gait changes among TBI athletes.

Date of publication

Spring 5-5-2021

Document Type




Persistent identifier


Committee members

Neil Dong, William Sorensen, Wycliffe Njororai Simiyu


Masters in Kinesiology

Available for download on Friday, May 05, 2023