Efficacy of Tandem Gait to Identify Impaired Postural Control after Concussion

Oldham, Jessie R.; DiFabio, Melissa S.; Kaminski, Thomas W.; DeWolf, Ryan; Howell, David R.; Buckley, Thomas A.

doi:10.1249/mss.0000000000001540

Cited by 72 publications

(73 citation statements)

References 32 publications

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“…Prior literature has noted that tandem gait has a sensitivity of 0.632, a specificity of 0.605, and an area under the curve of 0.704, which meet the sufficient level for diagnosis (area under the curve of 0.70 or higher). 23 The sensitivity and specificity of tandem gait have been reported to be greater than the sensitivity and specificity of the BESS, suggesting that tandem gait may be a more robust diagnostic tool than the BESS. 23 Tandem gait is similar to gait initiation as it is characterized by a series of purposeful steps in a specific direction (anterior).…”

Section: Clinical Gait Assessmentmentioning

confidence: 99%

“…2,4,17,18 The BESS is more commonly used by athletic trainers in concussion management and is scored using the total amount of errors committed during timed stances; however, the scoring is subjective and as such the psychometric properties of the BESS are poor. 8,[19][20][21][22][23] For example, the minimal detectable change, the minimal amount of change that is required to distinguish a true performance change from a change due to variability in performance or measurement error, for the BESS ranges from 7.3 to 9.4 errors where on average normal postconcussion changes range from 3 to 6 errors. This limits clinicians' abilities to identify balance deficits following injury.…”

Section: Current State Of Postural Control Assessment For Concussionmentioning

confidence: 99%

“…A potential clinical analog for gait initiation is tandem gait. 23,46,47 Tandem gait is clinically feasible and highly reliable to evaluate dynamic postural control along with being a part of the neurological screen in the SCAT-5. 23,48 Furthermore, it has been proposed to have better reliability and validity than the BESS and does not rely on subjective rater interpretation.…”

Section: Clinical Gait Assessmentmentioning

confidence: 99%

“…23,46,47 Tandem gait is clinically feasible and highly reliable to evaluate dynamic postural control along with being a part of the neurological screen in the SCAT-5. 23,48 Furthermore, it has been proposed to have better reliability and validity than the BESS and does not rely on subjective rater interpretation. 23 In addition, tandem gait can be used for a wide range of ages 46,49 and is clinician-friendly.…”

Section: Clinical Gait Assessmentmentioning

confidence: 99%

“…23,48 Furthermore, it has been proposed to have better reliability and validity than the BESS and does not rely on subjective rater interpretation. 23 In addition, tandem gait can be used for a wide range of ages 46,49 and is clinician-friendly.…”

Section: Clinical Gait Assessmentmentioning

confidence: 99%

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Clinical Assessments of Balance in Adults with Concussion: An Update

et al. 2019

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Postural instability is a cardinal indicator of concussion. Assessments of the postural control system range from clinical to laboratory tests that assess the balance of the individual. In a previous article regarding clinical assessment of balance in adults with concussion, we reviewed the importance of balance as a component in concussion evaluations. The purpose of this review article is to update the information previously published in 2014. Since 2014, research has provided evidence for the incorporation of dynamic methods for evaluating balance postconcussion with particular emphasis on sensory system integration and dual tasking. Therefore, this review will examine the current state of knowledge on how concussion injuries affect postural control, advancements in evaluating balance postconcussion, such as novel eye-tracking techniques, and current recommendations for best practices for balance assessment.

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Section: Clinical Gait Assessmentmentioning

confidence: 99%

Section: Current State Of Postural Control Assessment For Concussionmentioning

confidence: 99%

Section: Clinical Gait Assessmentmentioning

confidence: 99%

Section: Clinical Gait Assessmentmentioning

confidence: 99%

Section: Clinical Gait Assessmentmentioning

confidence: 99%

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Clinical Assessments of Balance in Adults with Concussion: An Update

et al. 2019

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Tandem gait test–retest reliability among healthy physically active young adults

Santo

Joyce

Lynall

2023

PM&R

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BackgroundA tandem gait assessment is recommended after concussion. There is limited research examining psychometric properties of tandem gait assessments.ObjectiveTo determine tandem gait test intertrial and 1‐week test–retest reliability. It was hypothesized that the tandem gait test would yield moderate to good reliability, times would improve across trials/sessions, and average scores would have higher reliability.DesignReliability study.SettingResearch laboratory.InterventionsSixty participants (36 females, age: 20.4 ± 1.8 years) completed 10 tandem gait test trials on two occasions.Main Outcome MeasuresDependent variables included number of normal trials (participants stayed on the line, heel and toe touched on every step, and they avoided touching an examiner/object) and times for each trial. We analyzed intertrial reliability using a one‐way analysis of covariance and intraclass correlation coefficients (ICC), and test–retest reliability using dependent samples t‐tests and ICCs.ResultsAt the first testing session, there were significant differences in times across seven trials (F2.44,80.42 = 21.55, p < .001). All trials were faster than the first trial. The second, third, and fifth trial were faster than the previous trial. There was moderately high overall reliability across the first seven trials (ICC2,1 = 0.77, 95% confidence interval = 0.63, 0.87). All times were faster at the second testing session (compared to the first). Most outcomes for the 1‐week test–retest reliability demonstrated at least moderate reliability, including the best times for the first three, four, and five trials; average times for the first four and five trials; and best and average times for all of the participants' normal trials during five and 10 attempted trials.ConclusionsThere are practice effects when administering multiple tandem gait test trials, but scores stabilize after the fifth trial. There are practice effects associated with multiple administrations of the tandem gait test, but outcomes using times for four or five trials have adequate 1‐week test–retest reliability in healthy physically active young adults.

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