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G. Singh1, A. Denny1, S. Amedure1, T. Sperl1, C. Laughlin1
1Russell Sage College, Physical Therapy, Troy, United States
Background: Concussions are mild traumatic brain injuries that impact cognitive and motor capacity. Lack of gold standard diagnostic criteria often results in overlooking motor deficits. Recent research has shown that dual-task costs increase in patients with concussion. Dual-task is the completion of a motor task in conjunction with a cognitive task. There is a need to understand the effects of concussion on dual task performance in adolescents and adults, which might streamline the process of developing standardized assessment tools.
Purpose: The purpose of this review is to understand the effects of a concussion injury on dual task performance in Adolescents.
Methods: The databases PubMed, CINAHL, Medline, and Science Direct were searched for appropriate articles, yielding 44 articles. Following the use of inclusion/exclusion criteria 18 articles were selected. 8 articles were omitted due to lack of information, lack or appropriate assessments, or lack of appropriate groups for comparison, resulting in 10 articles. All 10 articles were included in this systematic review. Five independent researchers completed critical analysis of the selected articles independently and through group discussions.
Results: The pooled sample size was 531 participants (Males: 315, Females: 216, Average Age Ranges: 15-16 and 19-20 years respectively). Eight of the ten studies measured gait velocity/walking speed of which 5 detected significant differences in gait speed between concussion and control groups, indicating that slower average gait velocities were present in individuals with concussion post-injury. 3/10 studies were able to quantify postural sway/ COM displacement during single and dual-task gait conditions reported that the concussion group demonstrated a statistically significant higher total amount of medial/lateral COM displacement, when compared to the healthy matched controls. The concussion group demonstrated the largest total amount of mediolateral COM displacement during the question and answer task, when compared to the other 3 cognitive tasks and control group. 4/10 studies assessed COM displacement velocity in both single and dual-task conditions and 3 were able to identify significant differences between concussion and control groups. Howell et al. (2013) found that both concussion and control groups’ COM displacement velocities significantly increased during dual-task gait conditions. 4/10 studies calculated cognitive task accuracy across single and dual task conditions between groups. Two of these four studies yielded significant results.
Conclusion(s): Dual task is significantly affected in individuals with concussion, which causes functional challenges in day to day life. More accurate assessment methods should be employed by the clinicians to understand both motor and cognitive deficits in concussion.
Implications: When considering return to play decisions, it is important to understand the definitions of clinical recovery versus physiological recovery and long term recovery. The importance of establishing a baseline with patients at risk for concussion should also be taken into consideration.
Funding, acknowledgements: NA
Keywords: Concussion, Dual Task, Adolescents
Topic: Neurology
Did this work require ethics approval? No
Institution: Russell Sage College
Committee: IRB
Reason: It is a systematic review completed by DPT students under the guidance of PT Faculty member
All authors, affiliations and abstracts have been published as submitted.
