Publications

Physical Activity and Aerobic Exercise After Concussion

• Howell DR, Brilliant AN, Oldham JR, Berkstresser B, Wang F, Meehan WP 3rd. Exercise in the first week following concussion among collegiate athletes: Preliminary findings. J Sci Med Sport. 2020 Feb;23(2):112-117.
• Wilson JC, Kirkwood MW, Potter MN, Wilson PE, Provance AJ, Howell DR. Early physical activity and clinical outcomes following pediatric sport-related concussion. J Clin Transl Res. 2020 Apr 16;5(4):161-168.
• Howell DR, Andrew Taylor J, Tan CO, Orr R, Meehan WP. The Role of Aerobic Exercise in Reducing Persistent Sport-related Concussion Symptoms. Med Sci Sports Exerc. 2019;51(4):613-619.
• Howell DR, Hunt DL, Aaron SE, Meehan WP 3rd, Tan CO. Influence of Aerobic Exercise Volume on Postconcussion Symptoms. Am J Sports Med. 2021 Jun;49(7):1912-1920.
• Krainin BM, Seehusen CN, Smulligan KL, Wingerson MJ, Wilson JC, Howell DR. Symptom and clinical recovery outcomes for pediatric concussion following early physical activity. J Neurosurg Pediatr. 2021 Sep 24:1-8.
• Howell DR, Hunt DL, Oldham JR, Aaron SE, Meehan WP 3rd, Tan CO. Postconcussion Exercise Volume Associations With Depression, Anxiety, and Dizziness Symptoms, and Postural Stability: Preliminary Findings. J Head Trauma Rehabil. 2021 Jul 26.
• Seehusen CN, Wilson JC, Walker GA, Reinking SE, Howell DR. More Physical Activity after Concussion Is Associated with Faster Return to Play among Adolescents. Int J Environ Res Public Health. 2021 Jul 9;18(14):7373.
• Howell DR, Wingerson MJ, Kirkwood MW, Grubenhoff JA, Wilson JC. Early aerobic exercise among adolescents at moderate/high risk for persistent post-concussion symptoms: A pilot randomized clinical trial. Phys Ther Sport. 2022 May;55:196-204.
• Smulligan KL, Wingerson MJ, Seehusen CN, Little CC, Wilson JC, Howell DR. More Physical Activity Is Correlated With Reduction in Kinesiophobia for Adolescents With Persistent Symptoms After Concussion. J Sport Rehabil. 2022 Oct 11;32(2):196-202.

Movement Deficits After Concussion

• Howell DR, Osternig LR, Chou L-S. Return to activity after concussion affects dual-task gait balance control recovery. Medicine & Science in Sports & Exercise. 2015;47(4):673-680.
• Howell DR, O’Brien MJ, Raghuram A, Shah A, Meehan WP. Near Point of Convergence and Gait Deficits in Adolescents Following Sport-Related Concussion. Clin J Sport Med. 2018;28(3):262-267.
• Howell DR, Lugade V, Potter MN, Walker G, Wilson JC. A multifaceted and clinically viable paradigm to quantify postural control impairments among adolescents with concussion. Physiol Meas. 2019 Sep 3;40(8):084006. Howell DR, Wilson JC, Brilliant AN, Gardner AJ, Iverson GL, Meehan WP 3rd. Objective clinical tests of dual-task dynamic postural control in youth athletes with concussion. J Sci Med Sport. 2019 May;22(5):521-525.
• Van Deventer KA, Seehusen CN, Walker GA, Wilson JC, Howell DR. The diagnostic and prognostic utility of the dual-task tandem gait test for pediatric concussion. J Sport Health Sci. 2021 Mar;10(2):131-137. Howell DR, Bonnette S, Diekfuss JA, Grooms DR, Myer GD, Meehan WP. Youth With Concussion Have Less Adaptable Gait Patterns Than Their Uninjured Peers: Implications for Concussion Management. J Orthop Sports Phys Ther.
• Howell DR, Myer GD, Brilliant A, Barber Foss K, Meehan WP 3rd. Quantitative Multimodal Assessment of Concussion Recovery in Youth Athletes. Clin J Sport Med. 2021 Mar 1;31(2):133-138.
• Wingerson MJ, Seehusen CN, Walker G, Wilson JC, Howell DR. Clinical feasibility and utility of a dual-task tandem gait protocol for pediatric concussion management. J Athl Train. 2020 Nov 5. Epub ahead of print.
• Howell DR, Seehusen CN, Wingerson MJ, Wilson JC, Lynall RC, Lugade V. Reliability and Minimal Detectable Change for a Smartphone-Based Motor-Cognitive Assessment: Implications for Concussion Management. J Appl Biomech. 2021 Jul 13:1-8.
• Barnes A, Smulligan K, Wingerson MJ, Little C, Lugade V, Wilson JC, Howell DR. A Multifaceted Approach to Interpreting Reaction Time Deficits After Adolescent Concussion. J Athl Train. 2023 Jan 27. Epub ahead of print. PMID: 36701688.
• Reinking S, Seehusen CN, Walker GA, Wilson JC, Howell DR. Transitory kinesiophobia after sport-related concussion and its correlation with reaction time. J Sci Med Sport. 2021 Jul

Concussion Prognosis

• Howell DR, Zemek R, Brilliant AN, Mannix RC, Master CL, Meehan WP. Identifying Persistent Postconcussion Symptom Risk in a Pediatric Sports Medicine Clinic. Am J Sports Med. 2018;46(13):3254-3261.
• Howell DR, Potter MN, Kirkwood MW, Wilson PE, Provance AJ, Wilson JC. Clinical predictors of symptom resolution for children and adolescents with sport-related concussion. J Neurosurg Pediatr. 2019 Apr 16;24(1):54-61.Howell DR, O’Brien MJ, Beasley MA, Mannix RC, Meehan WP. Initial somatic symptoms are associated with prolonged symptom duration following concussion in adolescents. Acta Paediatr. 2016;105(9):e426-432.
• Howell DR, Mayer AR, Master CL, Leddy J, Zemek R, Meier TB, Owen Yeates K, Arbogast KB, Mannix R, Meehan WP 3rd. Prognosis for Persistent Post Concussion Symptoms using a Multifaceted Objective Gait and Balance Assessment Approach. Gait Posture. 2020 Jun;79:53-59.
• Smulligan KL, Wingerson MJ, Seehusen CN, Wilson JC, Howell DR. Examining initial post-concussion dizziness and postural stability as predictors of time to symptom resolution. J Sci Med Sport. 2022 Jun;25(6):455-459.

Assessment and Intervention To Reduce Injury Risk After Concussion

• Howell DR, Buckley TA, Lynall RC, Meehan III WP. Worsening dual-task gait costs after concussion and their association with subsequent sport-related injury. Journal of Neurotrauma. 2018;35(14):1630-1636.
• Howell DR, Lynall RC, Buckley TA, Herman DC. Neuromuscular control deficits and the risk of subsequent injury after a concussion: a scoping review. Sports Med. 2018;48(5):1097-1115.
• Oldham JR, Howell DR, Knight CA, Crenshaw JR, Buckley TA. Gait Performance Is Associated with Subsequent Lower Extremity Injury following Concussion. Med Sci Sports Exerc. 2020 Nov;52(11):2279-2285.
• Howell DR, Bonnette S, Diekfuss JA, Grooms DR, Myer GD, Wilson JC, Meehan WP 3rd. Dual-Task Gait Stability after Concussion and Subsequent Injury: An Exploratory Investigation. Sensors (Basel). 2020 Nov 5;20(21):6297.
• Wilson JC, Carry PM, Daoud AK, Strunk S, Sweeney EA, Howell DR, Comstock RD. Single season re-injury risk after concussion and lower extremity injury among male, collision sport, high school athletes. J Sci Med Sport. 2021 Nov;24(11):1105-1109.
• Howell DR, Seehusen CN, Walker GA, Reinking S, Wilson JC. Neuromuscular training after concussion to improve motor and psychosocial outcomes: A feasibility trial. Phys Ther Sport. 2021 Aug 28;52:132-139.
• Howell DR, Seehusen CN, Carry PM, Walker GA, Reinking SE, Wilson JC. An 8-Week Neuromuscular Training Program After Concussion Reduces 1-Year Subsequent Injury Risk: A Randomized Clinical Trial. Am J Sports Med. 2022 Mar;50(4):1120-1129.

Concussion Biomarkers and Physiology

• Charney MF, Howell DR, Lanois C, Starr TC, Liao H, Coello E, Breedlove KM, Meehan WP 3rd, Koerte I, Lin AP. Associations Between Neurochemistry and Gait Performance Following Concussion in Collegiate Athletes. J Head Trauma Rehabil. 2020 Sep/Oct;35(5):342-353.
• Howell DR, Meehan WP 3rd, Barber Foss KD, Reches A, Weiss M, Myer GD. Reduced dual-task gait speed is associated with visual Go/No-Go brain network activation in children and adolescents with concussion. Brain Inj. 2018;32(9):1129-1134.
• Howell DR, Hunt DL, Aaron SE, Hamner JW, Meehan WP 3rd, Tan CO. Association of Hemodynamic and Cerebrovascular Responses to Exercise With Symptom Severity in Adolescents and Young Adults With Concussion. Neurology. 2021 Oct 11:10.1212/WNL.0000000000012929.
• Mannix R, Levy R, Zemek R, Yeates KO, Arbogast K, Meehan WP, Leddy J, Master C, Mayer AR, Howell DR, Meier TB. Fluid Biomarkers of Pediatric Mild Traumatic Brain Injury: A Systematic Review. J Neurotrauma. 2020 Oct 1;37(19):2029-2044. Howell DR, Kriz P, Mannix RC, Kirchberg T, Master CL, Meehan WP 3rd. Concussion Symptom Profiles Among Child, Adolescent, and Young Adult Athletes. Clin J Sport Med. 2019 Sep;29(5):391-397.
• Ozturk ED, Iaccarino MA, Hamner JW, Aaron SE, Hunt DL, Meehan WP 3rd, Howell DR, Tan CO. Executive dysfunction after multiple concussions is not related to cerebrovascular dysfunction. Physiol Meas. 2021 Sep 27;42(9)
• Daisy CC, Varinos S, Howell DR, Kaplan K, Mannix R, Meehan WP, Wang F, Berkstresser B, Lee RS, Froehlich JW, Zurakowski D, Moses MA. Proteomic Discovery of Noninvasive Biomarkers Associated With Sport-Related Concussions. Neurology. 2022 Jan 11;98(2):e186-e198. doi: 10.1212/WNL.0000000000013001. Epub 2021 Oct 21. PMID: 34675105; PMCID: PMC8762586.

Sex Differences and Patient-Specific Factors

• Gray M, Wilson JC, Potter M, Provance AJ, Howell DR. Female adolescents demonstrate greater oculomotor and vestibular dysfunction than male adolescents following concussion. Phys Ther Sport. 2020;42:68-74.
• Howell DR, Oldham J, Lanois C, Koerte I, Lin AP, Berkstresser B, Wang F, Meehan WP 3rd. Dual-Task Gait Recovery after Concussion among Female and Male Collegiate Athletes. Med Sci Sports Exerc. 2020 May;52(5):1015-1021. Howell DR, Stracciolini A, Geminiani E, Meehan III WP. Dual-task gait differences in female and male adolescents following sport-related concussion. Gait & Posture. 2017;54:284-289.
• Koerte IK, Schultz V, Sydnor VJ, Howell DR, Guenette JP, Dennis E, Kochsiek J, Kaufmann D, Sollmann N, Mondello S, Shenton ME, Lin AP. Sex-Related Differences in the Effects of Sports-Related Concussion: A Review. J Neuroimaging. 2020 Jul;30(4):387-409.
• Wingerson MJ, Wilson JC, Seehusen CN, Walker GA, Howell DR. Patient Characteristics Predictive of Immediate and Delayed Word Recall Performance Following Adolescent Concussion. Int J Sports Med. 2023 Jan;44(1):72-77. doi: 10.1055/a-1941-5673. Epub 2022 Sep 12. PMID: 36096148.
• Sidhar K, Baugh CM, Wilson JC, Spittler J, Walker GA, Armento AM, Howell DR. Socioeconomic status and injury history in adolescent athletes: Lower family affluence is associated with a history of concussion. J Clin Transl Res. 2022 Jul 18;8(4):292-298. PMID: 35975186; PMCID: PMC9373721.

Sleep After Concussion

• Howell DR, Oldham JR, Brilliant AN, William P.  Meehan III. Trouble Falling Asleep After Concussion Is Associated With Higher Symptom Burden Among Children and Adolescents: Journal of Child Neurology. 2019;34(5):256-261.
• Howell DR, Berkstresser B, Wang F, et al. Self-reported sleep duration affects tandem gait, but not steady-state gait outcomes among healthy collegiate athletes. Gait & Posture. 2018;62:291-296.
• Howell DR, Potter MN, Provance AJ, Wilson PE, Kirkwood MW, Wilson JC. Sleep Problems and Melatonin Prescription After Concussion Among Youth Athletes. Clin J Sport Med. 2020 Sep 29.
• Neely LM, Smulligan KL, Wingerson MJ, Seehusen CN, Simon SL, Wilson JC, Howell DR. The association between sleep and physical activity with persisting post-concussion symptoms among adolescent athletes. PM R. 2022 Dec 29. Epub ahead of print. PMID: 36580488.
• Smulligan KL, Wingerson MJ, Little CC, Wilson JC, Howell DR. Early physical activity after a concussion is associated with sleep quality but not dizziness among adolescent athletes. J Sci Med Sport. 2023 Feb 8:S1440-2440(23)00029-4. doi: 10.1016/j.jsams.2023.02.001. Epub ahead of print. PMID: 36804710.

Cervical Spine Dysfunction and Dizziness After Concussion

• Provance AJ, Howell DR, Potter MN, Wilson PE, D’Lauro AM, Wilson JC. Presence of Neck or Shoulder Pain Following Sport-Related Concussion Negatively Influences Recovery. J Child Neurol. 2020;35(7):456-462.
• Hunt DL, Oldham JR, Aaron SE, Tan CO, Meehan III WP, Howell DR. Dizziness, Psychosocial Function, and Postural Stability Following Sport-Related Concussion, Clin J Sport Med. 2021 Mar 09.
• Smulligan KL, Wilson JC, Seehusen CN, Wingerson MJ, Magliato SN, Howell DR. Post-Concussion Dizziness, Sleep Quality, and Postural Instability: A Cross-Sectional Investigation. J Athl Train. 2021 Oct 8.
• Smulligan KL, Wingerson MJ, Seehusen CN, Magliato SN, Wilson JC, Howell DR. Patient perception of dizziness and imbalance does not correlate with gait measures in adolescent athletes post-concussion. Gait Posture. 2021 Sep 20;90:289-294.
• Smulligan KL, Wingerson MJ, Seehusen CN, Wilson JC, Howell DR. Postconcussion Dizziness Severity Predicts Daily Step Count during Recovery among Adolescent Athletes. Med Sci Sports Exerc. 2022 Jun 1;54(6):905-911
• Smulligan KL, Wingerson MJ, Seehusen CN, Smith AC, Walker GA, Wilson JC, Howell DR. Dizziness Is Associated With Neck/Shoulder Pain Following Pediatric Concussion. Clin J Sport Med. 2022 Nov 1;32(6):e562-e567. Epub 2022 Jun 28. PMID: 36315824.
• Smulligan KL, Wingerson MJ, Seehusen CN, Wilson JC, Howell DR. Examining initial post-concussion dizziness and postural stability as predictors of time to symptom resolution. J Sci Med Sport. 2022 Jun;25(6):455-459. Epub 2022 Feb 4. PMID: 35221201.

Mental Health Concerns and Quality of Life After Concussion

• Howell DR, Wilson JC, Kirkwood MW, Grubenhoff JA. Quality of Life and Symptom Burden 1 Month After Concussion in Children and Adolescents. Clin Pediatr (Phila). 2019 Jan;58(1):42-49. Epub 2018 Oct 12. PMID: 30311786.
• Valovich McLeod TC, Snedden T, Halstead M, Wilson J, Master C, Grady M, Fazekas M, Santana J, Zaslow T, Miller S, Coel R, Howell DR; PRiSM Concussion Research Interest Group. Influence of Personal and Injury-Related Factors Predicting Deficits in Quality of Life Domains Among Pediatric Athletes: Findings From the Sport Concussion Outcomes in Pediatrics Study. Clin J Sport Med. 2023 Mar 1. Epub ahead of print. PMID: 36858431.
• Schmitz B, Smulligan KL, Wingerson MJ, Walker GA, Wilson JC, Howell DR. Double Vision and Light Sensitivity Symptoms are Associated With Return-to-School Timing After Pediatric Concussion. Clin J Sport Med. 2022 Nov 17. Epub ahead of print. PMID: 36395518.