Objective clinical tests of dual-task dynamic postural control in youth athletes with concussion

Objectives To prospectively evaluate single/dual-task timed-up-and-go (TUG) and tandem gait performance among children and adolescents with concussion and healthy controls. Design Repeated measures. Methods Participants with concussion (n = 23; age = 14.1 ± 2.5 years; 52% female) completed single/dual-task TUG, tandem gait, and symptom assessments 6.7 ± 2.6 and 23.3 ± 6.1 days post injury. The control group (n = 27; age = 14.1 ± 2.3 years; 48% female) completed the same protocol initially and 10.7 ± 16.1 days later. All participants completed single-task (undivided attention) and dual-task (divided attention) tests. The primary outcome variable was test completion time. Results The concussion group completed single-task (concussion group mean = 11.1 ± 1.9 vs. control group mean 9.9 ± 1.4 s, p = 0.027) and dual-task (concussion group mean = 14.4 ± 3.3 vs. control group mean 12.7 ± 1.9 s, p = 0.047) TUG tests slower than the control group across both time points. The concussion group completed dual-task tandem gait tests slower than the control group at both time points (21.3 ± 6.3 vs. 16.8 ± 5.5 s, p = 0.006), and were slower in the single-task condition at the first test (19.8 ± 5.4 vs. 13.8 ± 4.4 s, p = 0.003). Symptoms were significantly worse for the concussion group compared to the control group at the first (34.1 ± 21.4 vs. 3.9 ± 9.1, p Conclusions Slower dual-task TUG and tandem gait times were detected across both time points for the concussion group relative to the control group. In contrast, single-task tandem gait deficits appeared to improve in a similar fashion as symptoms, suggesting increased complexity from the addition of a cognitive task allows for the detection of persistent post-concussion deficits that might take longer to resolve.