Bryk Kelsey N, Passalugo Scott, Shan Chou Li-, Reisman Darcy S, Hafer Jocelyn F, Semrau Jennifer A, Buckley Thomas A
Department of Kinesiology and Applied Physiology, University of Delaware, DE; Biomechanics & Movement Sciences, University of Delaware, Newark, DE.
Iowa State University, Department of Human Sciences, Ames, IA.
Arch Phys Med Rehabil. 2024 Dec;105(12):2262-2268. doi: 10.1016/j.apmr.2024.08.007. Epub 2024 Aug 24.
To compare dual task cost (DTC) during gait initiation (GI) between a population of patients with persistent concussion symptoms (PCS) and age-matched healthy participants.
Cohort study.
University research center.
A cohort sample including 15 participants with PCS (43.9±11.7y, 73.3% female) and 23 age-matched healthy participants (42.1±10.3y, 65.2% female) as controls.
Participants were tested on a single occasion where they performed 5 trials of single task and 5 trials of dual task GI with 12-camera motion capture and 3 force plates.
The dependent variables of interest were the DTC for the center of pressure (COP) displacement and velocity during the anticipatory postural adjustment (APA) phase, the COP-center of mass (COP-COM) separation, and the response accuracy during the auditory cognitive tasks.
There were significant group differences with worse DTC for the PCS participants in anterior (A)/posterior (P) displacement (PCS, -37.5±22.1%; Control, -9.7±39.2%; P=.016, d=0.874), APA medial (M)/lateral (L) velocity (PCS, -34.8±28.8%; Control, -17.0±40.21%; P=.041, d=0.866), and the peak COP-COM separation (PCS, -7.3±6.7%; Control, 0.6±6.5%; P=.023, d=1.200). There were no significant group differences in the APA A/P velocity (PCS, -38.8±33.1%; Control, -19.8±43.9%; P=.094), APA M/L displacement (PCS, -34.8±21.8%; Control, -10.6±25.3%; P=.313), or cognitive task performance (PCS, -2.7±10.8%; Control, -0.2±4.3%; P=.321).
PCS participants had greater (worse) DTC during both the planning and execution of the task, with large effect sizes (d>0.80). PCS participants also used a posture-second strategy whereby attentional resources were inappropriately allocated to the cognitive task. These deficits may challenge a patient's ability to complete activities of daily living and limit their functional independence.
比较持续性脑震荡症状（PCS）患者群体与年龄匹配的健康参与者在步态起始（GI）过程中的双重任务成本（DTC）。
队列研究。
大学研究中心。
一个队列样本，包括15名PCS患者（43.9±11.7岁，73.3%为女性）和23名年龄匹配的健康参与者（42.1±10.3岁，65.2%为女性）作为对照。
参与者接受单次测试，在此期间他们使用12台摄像机动作捕捉系统和3块测力板进行5次单任务GI试验和5次双任务GI试验。
感兴趣的因变量包括预期姿势调整（APA）阶段压力中心（COP）位移和速度的DTC、COP与质心（COP-COM）的分离以及听觉认知任务期间的反应准确性。
两组之间存在显著差异，PCS参与者在前后（A）/后（P）位移方面的DTC更差（PCS，-37.5±22.1%；对照组，-9.7±39.2%；P = 0.016，d = 0.874），APA内侧（M）/外侧（L）速度方面（PCS，-34.8±28.8%；对照组，-17.0±40.21%；P = 0.041，d = 0.866），以及COP-COM分离峰值方面（PCS，-7.3±6.7%；对照组，0.6±6.5%；P = 0.023，d = 1.200）。在APA A/P速度（PCS，-38.8±33.1%；对照组，-19.8±43.9%；P = 0.094）、APA M/L位移（PCS，-34.8±21.8%；对照组，-10.6±25.3%；P = 0.313）或认知任务表现（PCS，-2.7±10.8%；对照组，-0.2±4.3%；P = 0.321）方面，两组之间无显著差异。
PCS参与者在任务规划和执行过程中都有更大（更差）的DTC，效应量较大（d>0.80）。PCS参与者还采用了姿势优先策略，即注意力资源被不适当地分配到认知任务上。这些缺陷可能会挑战患者完成日常生活活动的能力，并限制其功能独立性。
