Dual-Task Assessment Protocols in Concussion Assessment: A Systematic Literature Review

Kleiner, Michelle J.; Wong, Lynne; Dubé, Alexandra; Wnuk, Katie; Hunter, Susan; Graham, Laura

doi:10.2519/jospt.2018.7432

Cited by 52 publications

(40 citation statements)

References 57 publications

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“…The main goal of these therapies is to improve the capacity to perform daily life activities by reducing pain and improving their quality of life . However, those activities often require simultaneous cognitive and physical demands . In other words, daily life activities need the ability to carry out a primary motor task while attention is focused on an external source of attention (motor, cognitive, or emotional) .…”

Section: Introductionmentioning

confidence: 99%

“…12 However, those activities often require simultaneous cognitive and physical demands. 13 In other words, daily life activities need the ability to carry out a primary motor task while attention is focused on an external source of attention (motor, cognitive, or emotional). 14 This paradigm where two tasks are executed at the same time is called dual task.…”

Section: Introductionmentioning

confidence: 99%

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Effects of 24‐week exergame intervention on physical function under single‐ and dual‐task conditions in fibromyalgia: A randomized controlled trial

Martín-Martínez

Villafaina

Collado‐Mateo

et al. 2019

Scandinavian Med Sci Sports

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Objective To evaluate the effects of 24‐week exergame intervention in the physical fitness of women with fibromyalgia in both single‐ and dual‐task conditions. Design Single‐blinded, randomized controlled trial. Setting University facilities. Participants Fifty‐five women with fibromyalgia, recruited from the local fibromyalgia association, were randomly assigned to one of the two groups: exercise group and control group. Intervention The exercise group completed 24 weeks of supervised and group‐based exergame protocol, divided into two sessions of 60 minutes. The intervention was focused on mobility, postural control, upper and lower limbs coordination, aerobic fitness, and strength. Main outcome measures The strength of the upper limbs was measured using the arm curl test. The mobility skill was assessed through the timed‐up and go test, and the flexibility of both upper and lower limbs was measured using the back scratch and the sit and reach tests, respectively. Results Fifty participants completed the study. In the single‐task condition, exergame intervention led to significantly higher effects in the arm curl test (P = 0.008), sit and reach test (P = 0.033), and timed‐up and go test (P = 0.021). Moreover, under dual‐task condition, exergames led to significant effects in all the physical fitness tests (arm curl test, timed‐up and go test, back scratch test, and sit and reach test) compared to the control group. Conclusions Exergame is an effective tool to improve the physical fitness in women with fibromyalgia under single or dual‐task conditions.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of 24‐week exergame intervention on physical function under single‐ and dual‐task conditions in fibromyalgia: A randomized controlled trial

Martín-Martínez

Villafaina

Collado‐Mateo

et al. 2019

Scandinavian Med Sci Sports

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“…(3) Dualtask interventions are an evolving rehabilitation technique that show promise with more taxing and realistic exercise experience to simulate everyday life and sports activities. 39 For example, question and answer tasks (such as math problems) are combined with walking and can distinguish between individuals with and without history of mTBI. 39 Specifically, dualtask paradigms are thought to have potential to help more accurately detect when individuals after mTBI are not ready for full return to activity even when neuropsychological and PCS symptom scales appear normal.…”

Section: Exercise Intolerance and Active Treatmentmentioning

confidence: 99%

Physical Therapy Management of Adults with Mild Traumatic Brain Injury

Kane

Diaz

Moore³

2019

Semin Speech Lang

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Rehabilitation for individuals after mild traumatic brain injury (mTBI) or concussion requires emphasis on both cognitive and physical rest, with a gradual return to activity including sports. As the client becomes more active, the rehabilitation professional should pay close attention to symptoms associated with mTBI, such as headache, dizziness, nausea, and difficulty concentrating. The systematic approach to return to play provided by the Berlin Consensus Statement on Concussion in Sport can apply to adults with mTBI. This protocol calls for gradually increasing the intensity of physical activity while attending to postconcussion symptoms. During the incident that led to an mTBI, the injured individual may incur injuries to the vestibular and balance system that are best addressed by professionals with specific training in vestibular rehabilitation, most commonly physical therapists. Benign paroxysmal positional vertigo is a condition in which otoconia particles in the inner ear dislodge into the semicircular canals, resulting in severe vertigo and imbalance. This condition frequently resolves in a few sessions with a vestibular physical therapist. In conditions such as gaze instability, motion sensitivity, impaired postural control, and cervicogenic dizziness, improvement is more gradual and requires longer follow-up with a physical therapist and a home exercise program. In all of the above-stated conditions, it is essential to consider that a patient with protracted symptoms of mTBI or postconcussion syndrome will recover more slowly than others and should be monitored for symptoms throughout the intervention.

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“…The effects of concussion can last months after diagnosis, and many traditional tests do not detect persistent deficits. 3 The use of a dual-task assessment, which adds a cognitive load to a motor assessment, has the potential to be a more sensitive test of concussion. 4 The addition of a cognitive load may affect postural stability due to the finite amount of resources available to process loads simultaneously.…”

mentioning

confidence: 99%

“…Common dual-task assessments include postural stability assessments paired with a cognitive load such as the Stroop test. 3,4 The Stroop test, a visual, color-based load, has good test-retest reliability. 4 One of the first steps in the development of a tool to screen for musculoskeletal injury following concussion is to determine the reliability of the assessment in a healthy population.…”

mentioning

confidence: 99%

Postural Stability Under Dual-Task Conditions: Development of a Post-Concussion Assessment for Lower-Extremity Injury Risk

Westwood¹,

Killelea²,

Faherty³

et al. 2020

Journal of Sport Rehabilitation

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Context: Concussions are consequence of sports participation. Recent reports indicate there is an increased risk of lower-extremity musculoskeletal injury when returning to sport after concussion suggesting that achieving “normal” balance may not fully indicate the athlete is ready for competition. The increased risk of injury may indicate the need to refine a screening tool for clearance. Objective: Assess the between-session reliability and the effects of adding a cognitive task to static and dynamic postural stability testing in a healthy population. Setting: Clinical laboratory. Participants: Twelve healthy subjects (6 women; age 22.3 [2.9] y, height 174.4 [7.5] cm, weight 70.1 [12.7] kg) participated in this study. Design: Subjects underwent static and dynamic postural stability testing with and without the addition of a cognitive task (Stroop test). Test battery was repeated 10 days later. Dynamic postural stability testing consisted of a forward jump over a hurdle with a 1-legged landing. A stability index was calculated. Static postural stability was also assessed with and without the cognitive task during single-leg balance. Variability of each ground reaction force component was averaged. Main Outcome Measures: Interclass correlation coefficients (ICC2,1) were computed to determine the reliability. Standard error of measure, mean standard error, mean detectable change, and 95% confidence interval were all calculated. Results: Mean differences between sessions were low, with the majority of variables having moderate to excellent reliability (static .583–.877, dynamic .581–.939). The addition of the dual task did not have any significant effect on reliability of the task; however, generally, the ICC values improved (eyes open .583–.770, dual task .741–.808). Conclusions: The addition of a cognitive load to postural stability assessments had moderate to excellent reliability in a healthy population. These results provide initial evidence on the feasibility of dual-task postural stability testing when examining risk of lower-extremity musculoskeletal injury following return to sport in a concussed population.

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Dual-Task Assessment Protocols in Concussion Assessment: A Systematic Literature Review

Cited by 52 publications

References 57 publications

Effects of 24‐week exergame intervention on physical function under single‐ and dual‐task conditions in fibromyalgia: A randomized controlled trial

Effects of 24‐week exergame intervention on physical function under single‐ and dual‐task conditions in fibromyalgia: A randomized controlled trial

Physical Therapy Management of Adults with Mild Traumatic Brain Injury

Postural Stability Under Dual-Task Conditions: Development of a Post-Concussion Assessment for Lower-Extremity Injury Risk

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