Murray Nicholas G, Szekely Brian, Taylor Madison R, Quigley Kristen G, McCarley Joseph, Constantino Nora, Hashida Kumiko, Tamura Kaori
School of Public Health, Department of Kinesiology, University of Nevada, Reno, Nevada.
Department of Psychology, University of Nevada, Reno, Nevada.
Sports Health. 2024 Aug 7:19417381241264289. doi: 10.1177/19417381241264289.
This study evaluated 2 different dual-task (DT) conditions during tandem gait (TG) to predict sport-related concussion (SRC) diagnosis.
The best (fastest) single-task (ST) gait will differ between groups (controls vs SRC; baseline vs SRC), with auditory pure switching task (APST) response rate being the most important behavioral variable to aid prediction of SRC.
Cohort design.
Level 3.
A total of 409 National Collegiate Athletic Association Division I student-athlete controls and 21 team-physician-diagnosed SRC participated. All data were collected at preseason physicals (baseline) and within 7 days of injury for SRC. Each participant completed 3 conditions of TG in a pseudorandomized order: (1) ST, (2) DT with serial-7s (SS) subtractions, and (3) DT with APST. Outcomes of time-to-complete for TG and behavioral (eg, responses per second) for SS and APST were recorded for each trial.
ST Trials 2 ( = 0.03) and 3 ( = 0.01) were significantly different between controls and SRC. ST Trial 3 ( = 0.04) was significantly different between baseline and SRC. Average responses per second for APST were significantly different between- ( < 0.01) and within- ( = 0.01) group.
The results suggest that ST is significantly slower after SRC. However, DT (both SS and APST) time-to-complete are also important variables when predicting the SRC diagnosis. It is advised that both ST and DT be administered when making clinical decisions regarding postural instability after SRC.
The best ST TG time to complete gait is an important objective marker of concussion while DT paradigms, specifically SS and APST, are highly variable. DT may be more useful for clinical observable signs of SRC. Both SS and APST have unique usefulness, but APST response rate per second can be relied upon numerically for clinical decisions.
本研究评估了串联步态（TG）期间两种不同的双任务（DT）条件，以预测与运动相关的脑震荡（SRC）诊断。
最佳（最快）的单任务（ST）步态在不同组（对照组与SRC组；基线与SRC组）之间会有所不同，听觉纯切换任务（APST）的反应率是辅助预测SRC的最重要行为变量。
队列设计。
3级。
共有409名美国国家大学体育协会第一分区的学生运动员对照组和21名经队医诊断为SRC的患者参与。所有数据均在季前体检（基线）时以及SRC受伤后7天内收集。每位参与者以伪随机顺序完成3种TG条件：（1）ST，（2）带有连续7减法（SS）的DT，以及（3）带有APST的DT。记录每次试验中TG完成时间的结果以及SS和APST的行为结果（例如每秒反应次数）。
对照组与SRC组之间，ST试验2（P = 0.03）和试验3（P = 0.01）存在显著差异。基线与SRC组之间，ST试验3（P = 0.04）存在显著差异。APST的平均每秒反应次数在组间（P < 0.01）和组内（P = 0.01）均存在显著差异。
结果表明，SRC后ST明显变慢。然而，DT（SS和APST）的完成时间在预测SRC诊断时也是重要变量。建议在对SRC后的姿势不稳做出临床决策时，同时进行ST和DT测试。
完成步态的最佳ST TG时间是脑震荡的重要客观指标，而DT范式，特别是SS和APST，具有高度变异性。DT可能对SRC的临床可观察体征更有用。SS和APST都有独特的用途，但APST的每秒反应率在数值上可用于临床决策。
