scholarly journals CHANGES IN DUAL-TASK GAIT VELOCITY COST FOLLOWING CONCUSSION

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0009
Author(s):  
Kristin M. Ernest ◽  
Tyler Davis ◽  
Eric L Dugan
Keyword(s):  
Dual Task ◽  
Symptom Severity ◽  
Sports Medicine ◽  
Cognitive Task ◽  
Gait Velocity ◽  
Mechanism Of Injury ◽  
Severity Scores ◽  
Significant Difference ◽  
Main Effect ◽  
Within Subjects

Background: Changes in gait velocity have been identified in the literature between concussed and non-concussed individuals. Concussed patients demonstrate slower gait speed; the gait velocity cost has not been evaluated as extensively. Hypothesis: Hypothesis 1: Dual-task gait velocity cost will decrease at time of clearance compared to initial testing. Hypothesis 2: Subjects with a SRC will demonstrate greater decreases in gait velocity costs than those with non-SRC. Hypothesis 3: Symptom severity will be positively correlated to dual-task gait costs within the first 5 days after concussion. Methods: Patients evaluated for concussion in primary care sports medicine clinic within five days of injury were recruited between October 2017 and May 2019. The mechanism of injury was documented and used to classify sport-related (SRC) versus non sport-related (non-SRC) concussion. A standard concussion evaluation was performed at each visit to assess history, symptoms, neurocognitive, neuromuscular and vestibular dysfunction. Dual-task walking trials were incorporated with a cognitive task such as reciting the months of the year in reverse order or spelling words backwards. During the walking trials, gait velocity was measured using an Xsens MVN BIOMCH system (Xsens Technologies BV, Enschede, The Netherlands). A two-way mixed ANOVA with one within-subjects factor (time) and one between-groups factor (mechanism of injury) was used to determine if dual-task gait velocity costs differed over time and between those with a SRC versus those with a non-SRC. A Pearson’s product-moment correlation was used to assess the relationship between symptom severity scores and dual-task gait costs at initial visit. Results: There was no statistically significant interaction between the mechanism of injury and time on gait velocity cost, F(1, 79) = .033, p = .86. The main effect of time showed a statistically significant difference in mean gait velocity cost from initial to clearance, F(1, 79) = 6.19, p = 0.015, generalized η2 = .0.013. There was no main effect of mechanism of injury in mean gait velocity costs, F(1, 79) = 0.800, p = 0.374, generalized η2 = 0.008. There was a statistically significant, small positive correlation between symptom severity and dual-task gait velocity costs, r = .30, p < .007, with symptom severity explaining 9 % of the variation in dual-task gait velocity costs. Conclusion: The gait velocity cost demonstrates a statistically significant change from the time of injury to clearance in concussion patients. A small but significant relationship also exists between symptom severity and gait velocity cost.

scholarly journals A Mobile Device Dual-Task Paradigm for the Assessment of mTBI

2019 ◽  
Vol 184 (Supplement_1) ◽  
pp. 174-180 ◽  
Author(s):  
Susan M Linder ◽  
Mandy Miller Koop ◽  
Sarah Ozinga ◽  
Zachary Goldfarb ◽  
Jay L Alberts
Keyword(s):  
Mobile Device ◽  
Dual Task ◽  
Postural Stability ◽  
Cognitive Task ◽  
Eyes Closed ◽  
Number Discrimination ◽  
Significant Difference ◽  
Dual Task Paradigm ◽  
Using Data ◽  
Task Conditions

Abstract Research Objective Dual-task performance, in which individuals complete two or more activities simultaneously, is impaired following mild traumatic brain injury. The aim of this project was to develop a dual-task paradigm that may be conducive to military utilization in evaluating cognitive-motor function in a standardized and scalable manner by leveraging mobile device technology. Methods Fifty healthy young adult civilians (18–24 years) completed four balance stances and a number discrimination task under single- and dual-task conditions. Postural stability was quantified using data gathered from iPad’s native accelerometer and gyroscope. Cognitive task difficulty was manipulated by presenting stimuli at 30, 60, or 90 per minute. Performance of cognitive and balance tasks was compared between single- and dual-task trials. Results Cognitive performance from single- to dual-task paradigms showed no significant main effect of balance condition or the interaction of condition by frequency. From single- to dual-task conditions, a significant difference in postural control was revealed in only one stance: tandem with eyes closed, in which a slight improvement in postural stability was observed under dual-task conditions. Conclusion The optimal dual-task paradigm to evaluate cognitive-motor performance with minimal floor and ceiling effects consists of tandem stance with eyes closed while stimuli are presented at a rate of one per second.

Impact of Psychological Disorders on Clinical Presentation of Pediatric Patients Following a Concussion

Neurology ◽  
2021 ◽  
Vol 98 (1 Supplement 1) ◽  
pp. S21.1-S21
Author(s):  
Hannah Worrall ◽  
Shane Miller ◽  
Munro Cullum ◽  
Jane Chung
Keyword(s):  
Symptom Severity ◽  
Pediatric Patients ◽  
Clinical Presentation ◽  
Psychological Disorders ◽  
Initial Presentation ◽  
Multidisciplinary Teams ◽  
Severity Scores ◽  
Significant Difference ◽  
History Of ◽  
History Of Depression

ObjectiveTo examine differences in clinical symptom measures between pediatric patients with a history of depression and/or anxiety and no history of psychological disorders (PD) following a concussion.BackgroundLimited information exists regarding impact of pre-existing psychological disorders on initial clinical presentation in pediatric patients following concussion.Design/MethodsData were prospectively collected from participants aged 5–18 diagnosed with a concussion between August 2015 and March 2020. Demographics and clinical measures from initial presentation were reviewed, including SCAT-5 Symptom, Patient Health Questionnaire (PHQ-8), Generalized Anxiety Disorder (GAD-7) scale, and Brief Resiliency Scale (BRS). Participants were separated into 4 groups based on self-reported prior diagnosis: depression, anxiety, both, and no PD.ResultsOne thousand seven hundred seventy participants included: 50 depression, 82 anxiety, 84 both, and 1,554 no PD history. There was no significant difference in age, sex, prior concussion history, or time to presentation between the depression and no PD group, or the anxiety and no PD group. The both group was older, had more females and prior concussions, and presented later than the no PD group. The depression, anxiety, and both groups had higher rates of learning disorders than the no PD group (40%, 47.6%, 46.4% vs 16.4%, all p < 0.001). Each PD group had higher symptom severity scores than the no PD group. The PD groups all reported higher GAD-7 and PHQ-8 scores and lower BRS scores compared to the no PD group. The both group had the highest symptom severity, GAD-7, and PHQ-8 scores along with the lowest BRS score. All findings p = 0.001.ConclusionsDifferences were seen in participants with a history of depression and/or anxiety at initial clinical presentation, including history of learning disability, symptom severity scores, and screening tests for depression, anxiety, and resiliency compared to those without a history of PD. Understanding differences at initial presentation may urge providers to engage multidisciplinary teams in facilitating patient recovery.

A-144 Impairment of Attention in Persons with Post Traumatic Stress Disorder by Neuropsychology Assessments and Rehabilitation Training Course

2021 ◽  
Vol 36 (6) ◽  
pp. 1197-1198
Author(s):  
Oroub Almoula ◽  
Ahmad Almutairi ◽  
Abdullah Alozairi ◽  
Rudi Coetzer ◽  
Martyn Bracewell
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Positive Impact ◽  
Behavioural Therapy ◽  
Post Traumatic Stress ◽  
Control Practice ◽  
Cognitive Behavioural ◽  
Significant Difference ◽  
Main Effect ◽  
Within Subjects ◽  
Trail Making

Abstract Objective Scholars consider Mindfulness to develop a person’s capacity for awareness of self and others. This approach can also be used in Neuropsychological counselling. Recent research studies have shown that mindfulness has a positive impact on cognitive performance, attention and emotion regulation. This study aimed to examining a possible difference in attention trained between twenty PTSD Syrian’s refugees who were using the mindfulness programme for two weeks and those who trained Cognitive behavioural therapy course. This study was also intended to translate some widely used tests in neuropsychological assessments, and determining the potential efficiency of Mindfulness-based cognitive therapy as a rehabilitation course for these clinical populations. Two separate three-way mixed ANOVA models (Within-Within-Between) were performed to assess if the Stroop effect and Stroop R effect differ between the three Stroop scenarios (within-Subjects effect: Control – Practice – Main test) and Conditions (within-Subjects effect: Congruent – Incongruent) when two different separate treatments were applied to twenty Syrian’s refugees participants (Between-Subjects main effect: Mindfulness vs Cognitive behavioural therapy, there were also applied other attention measures such as; Trail Making test, Coding and Symbol search from WIAS-IV. For Stroop R model 2 we identified a significant within-subjects main effect of Stroop (F (2, 36) = 8.248, p = 0.002, partial-eta = 0.295). There was a significant within-subjects main effect of Conditions indicating a significant difference between congruent and incongruent treatment. Also, there was a significant two-way interaction effect of Stroop and Condition. Refugees participants reveal significantly differences for Coding, Trail numbers and Trail Numbers and Letters.

The 2-Min Walk Test Detects Dual-Task Deficits in Individuals With Parkinson’s Disease

2019 ◽  
Vol 27 (6) ◽  
pp. 843-847 ◽  
Author(s):  
Anson B. Rosenfeldt ◽  
Amanda L. Penko ◽  
Andrew S. Bazyk ◽  
Matthew C. Streicher ◽  
Tanujit Dey ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dual Task ◽  
Cognitive Task ◽  
The Self ◽  
Effective Model ◽  
Gait Velocity ◽  
Walk Test ◽  
Minimal Clinical Important Difference ◽  
Task Conditions

The aim of this project was to (a) evaluate the potential of the 2-min walk test to detect declines in gait velocity under dual-task conditions and (b) compare gait velocity overground and on a self-paced treadmill in Parkinson’s disease (PD). In total, 23 individuals with PD completed the 2-min walk test under single- and dual-task (serial 7s) conditions overground and on a self-paced treadmill. There was a significant decrease in gait velocity from single- to dual-task conditions overground (1.32 ± 0.22 to 1.10 ± 0.25 m/s; p < .001) and on the self-paced treadmill (1.24 ± 0.21 to 1.05 ± 0.25 m/s; p < .001). Overground and treadmill velocities were not statistically different from each other; however, differences approached or exceeded the minimal clinical important difference. The 2-min walk test coupled with a cognitive task provides an effective model of identifying dual-task declines in individuals with PD. Further studies comparing overground and self-paced treadmill velocity is warranted in PD.

scholarly journals INITIAL CLINICAL PRESENTATION OF PEDIATRIC PATIENTS WITH PSYCHOLOGICAL DISORDERS FOLLOWING CONCUSSION

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0008
Author(s):  
Hannah M. Worrall ◽  
Shane M. Miller ◽  
C. Munro Cullum ◽  
Jane S. Chung
Keyword(s):  
Symptom Severity ◽  
Pediatric Patients ◽  
Clinical Presentation ◽  
Anxiety And Depression ◽  
Anxiety Group ◽  
Severity Scores ◽  
Significant Difference ◽  
History Of ◽  
Concussion History ◽  
History Of Depression

Background: There is limited evidence regarding the impact of pre-existing psychological disorders on the initial clinical presentation in pediatric patients following concussion. Hypothesis/Purpose: To examine differences in clinical symptom measures between pediatric patients with a history of depression and/or anxiety and no history of psychological disorder (PD) following a concussion. Methods: Data were prospectively collected from participants enrolled in the North Texas Concussion Network Registry (ConTex) between August 2015 and March 2020. Participants aged 5-18 years diagnosed with a concussion were included. Demographic variables and a range of clinical measures from initial presentation were reviewed, including SCAT-5 Symptom Log, Patient Health Questionnaire (PHQ-8), Generalized Anxiety Disorder (GAD-7) scale, and Brief Resiliency Scale (BRS). Participants were separated into four groups based on self-reported prior diagnosis: depression, anxiety, depression+anxiety, and no PD. Results: A total of 1770 participants were included: 50 with depression, 82 with anxiety, 84 with both, and 1554 with no history of PD. There was no significant difference in age, sex, prior concussion history, or time to presentation between the depression and no PD group, or between the anxiety and no PD group. A significant difference was found between the depression+anxiety group and no PD group in the following variables: age (15.11±1.8 vs 13.68±2.61 years, p<0.001), prior concussion history (40.5% vs 23.9%, p=0.001), and time to presentation (31.47±25.82 vs 19.85±26.33 days, p=0.01). Additionally, there were more females in the depression+anxiety group than the no PD group (71.4% vs 47.8%, p<0.001). The depression, anxiety, and depression+anxiety groups had significantly higher rates of learning disorders than the no PD group (40%, 47.6%, 46.4% vs 16.4%, all p<0.001). A significant difference in SCAT-5 symptom severity scores between the depression, anxiety, and depression+anxiety groups compared to the no PD group was found. The PD groups all reported higher GAD-7 and PHQ-8 scores and lower BRS scores compared to the no PD group. The depression+anxiety group had the highest symptom severity, GAD-7, and PHQ-8 scores along with the lowest BRS score. Table 1.1 summarizes these significant findings. Conclusion: Differences were seen in participants with a history of depression and/or anxiety at initial clinical presentation, including history of learning disability, SCAT-5 symptom severity scores, and common screening tests for depression, anxiety, and resiliency compared to those without a history of PD. Understanding these differences at initial presentation may urge providers to engage multidisciplinary teams early in facilitating patient recovery. Tables/Figures: [Table: see text]

scholarly journals Regional Differences in Various Risk Factors for Postpartum Depression: Applying Mixed Models to the PRAMS Dataset

2021 ◽  
Vol 2 ◽  
Author(s):  
Janace J. Gifford ◽  
Jenna R. Pluchino ◽  
Rebecca Della Valle ◽  
Jaclyn M. Schwarz
Keyword(s):  
Risk Factors ◽  
Postpartum Depression ◽  
Symptom Severity ◽  
Hierarchical Linear Model ◽  
Well Being ◽  
Depression Symptoms ◽  
Depression Symptom ◽  
Depression Diagnosis ◽  
Severity Scores ◽  
Significant Difference

Purpose: The purpose of this study was to assess the association between various risk factors with postpartum depression severity using a large dataset that included variables such as previous mental health status, social factors, societal factors, health care access, and other state-wide or region-specific variables.Methods: We obtained the most recently available (2016–2017) dataset from the Pregnancy Risk Assessment Monitoring System (PRAMS), which is a dataset compiled by the Centers for Disease Control (CDC) that collects state-specific, population-based data on maternal attitudes and experiences before, during, and shortly after pregnancy from over 73,000 women in 39 states. We utilized a hierarchical linear model to analyze the data across various levels, with a symptom severity scale (0–8) as the dependent variable.Results: Of the 21 variables included in the final model, nine variables were statistically significant predictors of symptom severity. Statistically significant predictors of increased postpartum depression symptom severity included previous depression diagnosis and depression symptoms during pregnancy, baby not residing with mother, unintentional pregnancy, women with less than a high school degree and more than a college degree, Women Infants Children (WIC) enrollment, and married women. In contrast to these other factors, attendance at a postpartum follow up appointment was associated with significantly increased symptom severity. Age revealed an inverted curve in predicting postpartum symptom severity.Conclusions: There was no significant difference in symptom severity scores across the 39 participating states. Most notably, postpartum depression symptom severity was associated with previous depression diagnosis and previous symptom severity, but our results also reveal novel social and education factors that contribute to the support and well-being of the mother and child.

Turn Characteristics During Gait Differ With and Without a Cognitive Demand Among College Athletes

2020 ◽  
Vol 29 (4) ◽  
pp. 448-453
Author(s):  
Lauren A. Brown ◽  
Eric E. Hall ◽  
Caroline J. Ketcham ◽  
Kirtida Patel ◽  
Thomas A. Buckley ◽  
...  
Keyword(s):  
Cognitive Load ◽  
Dual Task ◽  
Sports Medicine ◽  
College Athletes ◽  
Cognitive Task ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Dual Task Condition ◽  
Dual Tasking ◽  
Task Conditions

Context: Sports often involve complex movement patterns, such as turning. Although cognitive load effects on gait patterns are well known, little is known on how it affects biomechanics of turning gait among athletes. Such information could help evaluate how concussion affects turning gait required for daily living and sports. Objective: To determine the effect of a dual task on biomechanics of turning while walking among college athletes. Design: Cross-sectional study. Setting: University laboratory. Participants: Fifty-three participants performed 5 trials of a 20-m walk under single- and dual-task conditions at self-selected speed with a 180° turn at 10-m mark. The cognitive load included subtraction, spelling words backward, or reciting the months backward. Interventions: Not applicable. Main Outcome Measures: Turn duration, turning velocity, number of steps, SD of turn duration and velocity, and coefficient of variation of turn duration and velocity. Results: Participants turned significantly slower (155.99 [3.71] cm/s vs 183.52 [4.17] cm/s; P < .001) and took longer time to complete the turn (2.63 [0.05] s vs 2.33 [0.04] s; P < .001) while dual tasking, albeit taking similar number of steps to complete the turn. Participants also showed more variability in turning time under the dual-task condition (SD of turn duration = 0.39 vs 0.31 s; P = .004). Conclusions: Overall, college athletes turned slower and showed more variability during turning gait while performing a concurrent cognitive dual-task turning compared with single-task turning. The slower velocity increased variability may be representative of specific strategy of turning gait while dual tasking, which may be a result of the split attention to perform the cognitive task. The current study provides descriptive values of absolute and variability turning gait parameters for sports medicine personnel to use while they perform their concussion assessments on their college athletes.

P2-342: CEREBROVASCULAR HEMODYNAMICS AND GAIT VELOCITY DURING A COGNITIVE TASK (DUAL TASK GAIT): RACIAL DIFFERENCES IN MIDLIFE

2006 ◽  
Vol 14 (7S_Part_15) ◽  
pp. P816-P817
Author(s):  
Chaney R. Garner ◽  
Cristina Duque ◽  
Can Ozan Tan ◽  
Sanaz Sedaghat ◽  
Shawn Kurian ◽  
...  
Keyword(s):  
Racial Differences ◽  
Dual Task ◽  
Cognitive Task ◽  
Gait Velocity ◽  
Cerebrovascular Hemodynamics

scholarly journals Influence of age on postural control during dual task: a centre of pressure motion and electromyographic analysis

2021 ◽  
Author(s):  
Enrico Roma ◽  
Stefano Gobbo ◽  
Valentina Bullo ◽  
Fabiola Spolaor ◽  
Zimi Sawacha ◽  
...  
Keyword(s):  
Postural Control ◽  
Dual Task ◽  
Secondary Task ◽  
Muscle Activation ◽  
Cognitive Task ◽  
Erector Spinae ◽  
Centre Of Pressure ◽  
Eyes Closed ◽  
Main Effect ◽  
Electromyographic Analysis

Abstract Background Dual task influences postural control. A cognitive task seems to reduce muscle excitation during a postural balance, especially in older adults (OA). Aim The aim of this study is to evaluate the effect of three cognitive tasks on muscle excitation and static postural control in OA and young adults (YA) in an upright posture maintenance task. Methods 31 YA and 30 OA were evaluated while performing a modified Romberg Test in five different conditions over a force plate: open eyes, closed eyes, spatial-memory brooks’ test, counting backwards aloud test and mental arithmetic task. The surface electromyographic signals of Tibialis anterior (TA), Lateral Gastrocnemius (GL), Peroneus Longus (PL), and Erector Spinae (ES) was acquired with an 8-channel surface electromyographic system. The following variables were computed for both the electromyographic analysis and the posturographic assessment: Root mean square (RMS), centre of pressure (CoP) excursion (Path) and velocity, sway area, RMS of the CoP Path and 50%, 95% of the power frequency. Mixed ANOVA was used to detect differences with group membership as factor between and type of task as within. The analysis was performed on the differences between each condition from OE. Results An interaction effect was found for Log (logarithmic) Sway Area. A main effect for task emerged on all posturographic variables except Log 95% frequencies and for Log PL and ES RMS. A main effect for group was never detected. Discussion and conclusion This study indicates a facilitating effect of mental secondary task on posturographic variables. Non-silent secondary task causes increase in ES and TA muscle activation and a worsening in static postural control performance.

Postconcussive Symptoms After Blast and Nonblast-Related Mild Traumatic Brain Injuries in Afghanistan and Iraq War Veterans

2010 ◽  
Vol 16 (5) ◽  
pp. 856-866 ◽  
Author(s):  
SARA M. LIPPA ◽  
NICHOLAS J. PASTOREK ◽  
JARED F. BENGE ◽  
G. MATTHEW THORNTON
Keyword(s):  
Posttraumatic Stress ◽  
Symptom Severity ◽  
Brain Injuries ◽  
Symptom Cluster ◽  
Posttraumatic Stress Symptoms ◽  
Mechanism Of Injury ◽  
Symptom Report ◽  
Stress Symptoms ◽  
Postconcussive Symptoms ◽  
Significant Difference

AbstractBlast injury is common in current warfare, but little is known about the effects of blast-related mild traumatic brain injury (mTBI). Profile analyses were conducted investigating differences in self-reported postconcussive (PC) symptoms in 339 veteran outpatients with mTBI histories reporting current symptoms based on mechanism of injury (blast only, nonblast only, or both blast and nonblast), number of blast injuries, and distance from the blast. Veterans with any blast-related mTBI history were younger and reported higher posttraumatic stress symptoms than veterans with nonblast-related mTBI histories, with a marginally significant difference in posttraumatic stress symptom report between veterans reporting blast-related mTBI only and those reporting nonblast-related mTBI. The groups did not differ in terms of PC symptom severity or PC symptom cluster profiles. Among veterans with blast-related mTBI histories, PC symptom report did not vary by number of blast-related mTBIs or proximity to blast. Overall, posttraumatic stress symptoms accounted for a substantial portion of variance in PC symptom report. In veteran outpatients with remote mTBI histories who have enduring symptom complaints related to the mTBI, mechanism of injury did not clearly contribute to differential PC symptom severity or PC symptom cluster profile. Proximal rather than distal factors may be important intervention targets in returning symptomatic veterans with mTBI histories. (JINS, 2010, 16, 856–866.)

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