Detection of acute and long-term effects of concussion: dual-task gait balance control vs. computerized neurocognitive test

Publication date: Available online 16 February 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): David R. Howell, Louis R. Osternig, Li-Shan Chou
ObjectiveOur 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.DesignLongitudinal case-controlSettingMotion analysis laboratoryParticipantsParticipants 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.InterventionsNot applicableMain Outcome MeasuresWe 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.ResultsNinety-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.ConclusionsDual-task assessments concurrently evaluating gait and cognitive performance may allow for the detection of persistent deficits beyond those detected by computerized neurocognitive deficits alone.



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