Citation

Kleiner M, Wong L, Dubé A, Wnuk K, Hunter SW, Graham LJ. J. Orthop. Sports Phys. Ther. 2018; 48(2): 87-103.

Affiliation

School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, ON, Canada.

Copyright

(Copyright © 2018, Orthopaedic Section and Sports Physical Therapy Section of the American Physical Therapy Association)

DOI

10.2519/jospt.2018.7432

PMID

29113571

Abstract

Study Design Systematic review. Background When assessed in isolation, balance and neurocognitive testing may not be sufficiently responsive to capture changes that occur with concussion. Normal daily activities require simultaneous cognitive and physical demands. Therefore, a dual-task assessment paradigm should be considered to identify performance deficits.

OBJECTIVEs To evaluate the literature and identify dual-task testing protocols associated with changes in gait after concussion.

METHODS A systematic review of articles of individuals with concussion who underwent dual-task testing with a combination of motor and cognitive tasks. AMED, CINAHL, EMBASE, PsycINFO, PubMed, Scopus, SPORTDiscus, and Web of Science databases and grey literature were searched from inception to January 29, 2017. Title and abstract, full-text, quality review and data abstraction were performed by two independent reviewers.

RESULTS Twenty-four articles met the inclusion criteria. Eleven articles reported decreased gait velocity and increased medial-lateral displacement for individuals with concussion during dual-task conditions. Overall, included articles were of poor to moderate methodological quality. Fifteen articles used the same participants and datasets creating a threat to validity limiting the ability to make conclusions.

CONCLUSION A deterioration in gait performance during dual-task testing is present among people with concussion. Specific recommendations for a dual-task protocol that may be used in clinical practice to assess individuals with a suspected concussion injury has yet to be determined and merits further research. J Orthop Sports Phys Ther, Epub 7 Nov 2017. doi:10.2519/jospt.2018.7432.

Language: en

Keywords

cognition; concussion; divided attention; gait; mild traumatic brain injury; motor task