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Single-task and dual-task tandem gait test performance after concussion
  1. David R Howell1,2,3,
  2. Louis R Osternig4,
  3. Li-Shan Chou4
  1. 1The Micheli Center for Sports Injury Prevention, Waltham, MA, USA
  2. 2Division of Sports Medicine, Department of Orthopaedics, Boston Childrens Hospital, Boston, MA, USA
  3. 3Brain Injury Center, Boston Childrens Hospital, Boston, MA, USA
  4. 4Department of Human Physiology, University of Oregon, Eugene, OR, USA.


Objective To examine tandem gait test (TGT) performance during single-task and dual-task conditions.

Design Prospective, longitudinal observational study

Setting Motion analysis laboratory

Participants Ten post-concussion (30% F, 19.0 [95% CI=15.6–22.4] years) and 7 control (57% F, 20.0 [16.7 -23.3] years) participants completed the TGT in single-task and dual-task conditions within 72 hours of sustaining a concussion and again at 1 week, 2 weeks, 1 month, and 2 months post-injury. Exclusion criteria included a current lower extremity injury, diagnosed learning disability, or documented prior concussion within the past year.

Independent variables TGT trials were performed without (single-task) and while concurrently performing a cognitive test (dual-task).

Outcome measures Participants completed 3 trials in each condition while whole body motion capture was performed. Outcome variables included the average completion time for the 3 trials, mean center-of-mass gait velocity, and cadence.

Main results Concussion participants took significantly longer to complete the dual-task TGT than controls (16.4 [13.4 -19.4] vs. 10.1 [6.4 -13.7] seconds) at the 72 hour, 1 week, and 2 week time points (p=.03); single-task TGT times were significantly lower 72 hours post-injury only (p=.04). Cadence was significantly lower for concussion participants across the two month testing period during dual-task TGT (89.5 [68.6 -110.4] vs. 127.0 [97.4 -156.6] steps/minute; p=.04). Mean gait velocity was lower for concussion participants at 72 hours post-injury in both conditions.

Conclusions Dual-task TGT deficits lasted longer for concussion participants than single-task TGT deficits. Including a secondary task during dynamic assessments of gait after concussion may increase the sensitivity to movement deficits that are undetectable using single-tasks.

Competing interests The authors have no conflicts of interest to report.

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