Citation

Howell DR, Osternig LR, Chou LS. Arch. Phys. Med. Rehabil. 2018; 99(7): 1318-1324.

Affiliation

Department of Human Physiology, University of Oregon, Eugene, OR, USA. Electronic address: chou@uoregon.edu.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.apmr.2018.01.025

PMID

29457997

Abstract

OBJECTIVE: Our aim was to examine the acute (within 72 hours of injury) and long-term (2 months post-injury) independent associations between objective dual-task gait balance and neurocognitive measurements among adolescents and young adults with a concussion and matched controls.

DESIGN: Longitudinal case-control SETTING: Motion analysis laboratory PARTICIPANTS: Participants who sustained a concussion underwent a dual-task gait analysis and computerized neurocognitive testing within 72 hours of injury and again 2 months later. Uninjured controls also completed the same test protocol in similar time increments. INTERVENTIONS: Not applicable MAIN OUTCOME MEASURES: We compared dual-task gait balance control and computerized neurocognitive test performance between groups using independent samples t-tests. Multivariable binary logistic regression models were then constructed for each testing time to determine the association between group membership (concussion vs. control), dual-task gait balance control, and neurocognitive function.

RESULTS: Ninety-five participants completed the study, 51 who sustained a concussion (mean age= 17.5±3.3 years; 71% male) and 44 controls (mean age= 17.7±2.9 years; 72% male). Medial-lateral center-of-mass displacement during dual-task gait was independently associated group membership at the initial test (adjusted odds ratio [aOR]= 2.432, 95% CI= 1.269-4.661) and 2 month follow-up test (aOR= 1.817, 95% CI= 1.014-3.256) tests. Visual memory composite scores were significantly associated with group membership at the initial hour post-injury time point (aOR= 0.953, 95% CI= 0.833-0.998). However, the combination of computerized neurocognitive test variables did not predict dual-task gait balance control for concussion participants, and no single neurocognitive variable was associated with dual-task gait balance control at either testing time.

CONCLUSIONS: Dual-task assessments concurrently evaluating gait and cognitive performance may allow for the detection of persistent deficits beyond those detected by computerized neurocognitive deficits alone.

Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Language: en

Keywords

attention; balance; locomotion; mild traumatic brain injury; neuropsychological function