Single-task and dual-task tandem gait test performance after concussion.
OBJECTIVE
To compare single-task and dual-task tandem gait test performance between athletes after concussion with controls on observer-timed, spatio-temporal, and center-of-mass (COM) balance control measurements.


METHODS
Ten participants (19.0±5.5years) were prospectively identified and completed a tandem gait test protocol within 72h of concussion and again 1 week, 2 weeks, 1 month, and 2 months post-injury. Seven uninjured controls (20.0±4.5years) completed the same protocol in similar time increments.


METHODS
Tandem gait test trials were performed with (dual-task) and without (single-task) concurrently performing a cognitive test as whole-body motion analysis was performed. Outcome variables included test completion time, average tandem gait velocity, cadence, and whole-body COM frontal plane displacement.


RESULTS
Concussion participants took significantly longer to complete the dual-task tandem gait test than controls throughout the first 2 weeks post-injury (mean time=16.4 [95% CI: 13.4-19.4] vs. 10.1 [95% CI: 6.4-13.7] seconds; p=0.03). Single-task tandem gait times were significantly lower 72h post-injury (p=0.04). Dual-task cadence was significantly lower for concussion participants than controls (89.5 [95% CI: 68.6-110.4] vs. 127.0 [95% CI: 97.4-156.6] steps/minute; p=0.04). Moderately-high to high correlations between tandem gait test time and whole-body COM medial-lateral displacement were detected at each time point during dual-task gait (rs=0.70-0.93; p=0.03-0.001).


CONCLUSIONS
Adding a cognitive task during the tandem gait test resulted in longer detectable deficits post-concussion compared to the traditional single-task tandem gait test. As a clinical tool to assess dynamic motor function, tandem gait may assist with return to sport decisions after concussion.
The Micheli Center for Sports Injury Prevention, USA; Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, USA; Brain Injury Center, Boston Children's Hospital, USA.
David R
DR
Howell
Motion Analysis Laboratory, Department of Human Physiology, University of Oregon, USA.
Louis R
LR
Osternig
Motion Analysis Laboratory, Department of Human Physiology, University of Oregon, USA. Electronic address: chou@uoregon.edu.
Li-Shan
LS
Chou
D000293:Adolescent; D056352:Athletes; D001924:Brain Concussion / Q000503:physiopathology*; D016022:Case-Control Studies; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D004856:Postural Balance; D000072797:Walking Speed; D055815:Young Adult
Balance; Concussion; Dual-task; Locomotion; Mild traumatic brain injury; Tandem gait