Dataset Information

Dual task cost in adults with persistent concussion symptoms.

ABSTRACT:

Background

Persistent concussion symptoms (PCS) negatively affects common activities of daily living including deficits in both single and dual-task (DT) gait. DT gait deficits are present post-concussion; however, task prioritization and the effects of differing cognitive challenge remain unexplored in the PCS population.

Research question

The purpose of this study was to investigate single and dual-task gait performance in individuals with persistent concussion symptoms and to identify task priorization strategies during DT trials.

Methods

Fifteen adults with PCS (age: 43.9+11.7 y.o.) and 23 healthy control participants (age: 42.1+10.3 y.o.) completed five trials of single task gait followed by fifteen trials of dual task gait along a 10-m walkway. The cognitive challenges consisted of five trials each of visual stroop, verbal fluency, and working memory cognitive challenges. Groups were compared on DT cost stepping characteristics with independent samples t-test or Mann-Whitney U tests.

Results

There were significant overall gait Dual Task Cost (DTC)difference between groups for gait speed (p = 0.009, d=0.92) and step length (p = 0.023, d=0.76). Specific to each DT challenge, PCS participants were slower during Verbal Fluency (0.98 + 0.15 m/s and 1.12 + 0.12 m/s, p = 0.008; d=1.03), Visual Stroop (1.06 + 0.19 m/s and 1.20 + 0.12 m/s, p = 0.012, d=0.88), and Working Memory (1.02 + 0.15 m/s and 1.16 + 0.14 m/s, p = 0.006, d=0.96). There were significant cognitive DTC differences between groups for WM accuracy (p = 0.008, d=0.96), but not for VS accuracy (p = 0.841, d=0.061) or VF total words (p = 0.112, d=0.56).

Significance

The PCS participants displayed a posture-second strategy whereby gait performance generally decreased in the absence of cognitive changes. However, during the Working Memory DT, PCS participants had a mutual interference response whereby both motor and cognitive performance decreased suggesting the cognitive task plays a key role in the DT gait performance of PCS patients.

SUBMITTER: Bryk KN

PROVIDER: S-EPMC10023483 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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Publications

Dual task cost in adults with persistent concussion symptoms.

Bryk Kelsey N KN Passalugo Scott S Chou Li-Shan LS Reisman Darcy R DR Hafer Jocelyn J Semrau Jennifer A JA Buckley Thomas A TA

Gait & posture 20230211

<h4>Background</h4>Persistent concussion symptoms (PCS) negatively affects common activities of daily living including deficits in both single and dual-task (DT) gait. DT gait deficits are present post-concussion; however, task prioritization and the effects of differing cognitive challenge remain unexplored in the PCS population.<h4>Research question</h4>The purpose of this study was to investigate single and dual-task gait performance in individuals with persistent concussion symptoms and to i ...[more]

PMID: 36796161

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Project description:BackgroundThe tandem gait test has gained interest recently for assessment of concussion recovery. The purpose of our study was to determine the prognostic and diagnostic use of the single- and dual-task tandem gait test, alongside other clinical measures, within 10 days of pediatric concussion.MethodsWe assessed 126 patients post-concussion (6.3 ± 2.3 days post-injury, mean ± SD) at a pediatric sports medicine clinic and compared them to 58 healthy controls (age: 15.6 ± 1.3 years; 43% female). We also compared the 31 patients with concussion who developed persistent post-concussion symptoms (PPCS) (age = 14.9 ± 2.0 years; 48% female) to the 81 patients with concussion who did not develop PPCS following the initial assessment (age: 14.1 ± 3.0 years; 41% female). All subjects completed a test battery, and concussion patients were monitored until they experienced concussion-symptom resolution. The test battery included tandem gait (single-task, dual-task (performing tandem gait while concurrently completing a cognitive test) conditions), modified Balance Error Scoring System (mBESS), and concussion symptom assessment (Health and Behavior Inventory). We defined PPCS as symptom resolution time > 28 days post-concussion for the concussion group. Measurement outcomes included tandem gait time (single- and dual-task), dual-task cognitive accuracy, mBESS errors (single/double/tandem stances), and symptom severity.ResultsThe concussion group completed the single-task (mean difference = 9.1 s, 95% confidential interval (95%CI): 6.1-12.1) and dual-task (mean difference = 12.7 s, 95%CI: 8.7-16.8) tandem gait test more slowly than the control group. Compared to those who recovered within 28 days of concussion, the PPCS group had slower dual-task tandem gait test times (mean difference = 7.9 s, 95%CI: 2.0-13.9), made more tandem-stance mBESS errors (mean difference = 1.3 errors, 95%CI: 0.2-2.3), and reported more severe symptoms (mean difference = 26.6 Health and Behavior Inventory rating, 95%CI: 21.1-32.6).ConclusionWorse dual-task tandem gait test time and mBESS tandem stance performance predicted PPCS in pediatric patients evaluated within 10 days of concussion. Tandem gait assessments may provide valuable information augmenting common clinical practices for concussion management.

Project description:ObjectiveConcussion is a common yet heterogenous injury. Approximately 15-30% of cases present with persistent post-concussion symptoms (PPCS), continuing 4 weeks or more post-injury in children, youth, and adolescents, and 3 months or more in adults. There are known bidirectional links between PPCS and mental health outcomes. The focus of this scoping review is to explore the literature on mental health outcomes in individuals experiencing PPCS. Research objectives were to explore: (1) the mental health outcomes of individuals with PPCS and types of assessments used to identify mental health outcomes this group, and (2) how mental health outcomes compare in terms of similarities and differences among pediatric and adult populations with PPCS.MethodOvid MEDLINE; EMBASE; CINAHL, and PsycInfo databases were searched. After title and abstract screening of 11,920 studies, 481 articles were reviewed. Twenty-five papers met inclusion criteria. Results were organized by mental health outcomes of pediatric and adult populations, separately.ResultsThere was a significantly higher number of studies devoted to adult populations. Of the 25 studies, 19 (76%) focused on adults, while six (24%) focused on adolescents. In adult populations, studies focused on symptoms of: anxiety (n = 2), depression (n = 8), and anxiety and depression (n = 9). Two studies assessed other emotional outcomes (10.5%). Within pediatric populations, an equal number of studies explored symptoms of: anxiety (n = 2), depression (n = 2), and anxiety and depression (n = 2). No studies focused on other emotional outcomes. Studies ranged greatly in methods, design, and control group. Most studies reported higher psychiatric symptoms of anxiety and/or depression in those with PPCS compared to individuals with recovered concussion or healthy controls.DiscussionThis review contributes to the understanding of mental health outcomes in those experiencing PPCS. Mental health and PPCS requires greater attention in pediatric populations, and consider strategies for those experiencing PPCS and mental health impacts. Future studies should consider including a wider range of emotional outcomes in their design, not limited to anxiety and depression. Study results may lead to improvements and research in the identification, assessment, and management of PPCS and mental health.

Dataset Information

Dual task cost in adults with persistent concussion symptoms.

Background

Research question

Methods

Results

Significance

Publications

Dual task cost in adults with persistent concussion symptoms.

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