scholarly journals Clinical feasibility and utility of a dual-task tandem gait protocol for pediatric concussion management

2020 ◽  
Author(s):  
Mathew J. Wingerson ◽  
Corrine N. Seehusen ◽  
Gregory Walker ◽  
Julie C. Wilson ◽  
David R. Howell
Keyword(s):  
Dual Task ◽  
Motor Performance ◽  
Clinical Utility ◽  
Correlation Coefficients ◽  
Single Task ◽  
Task Trial ◽  
Task Conditions ◽  
And Control ◽  
Test Completion ◽  
Tandem Gait

Abstract Context: Clinical management of sport-related concussion requires the assessment of various factors, including motor performance. The tandem gait test, a measure of post-injury motor performance, has demonstrated clinical utility, but is limited by time availability and test uniformity. Objective: To assess intrasession reliability between tandem gait test trials and determine the number trials necessary for optimal utility and feasibility in clinical decision-making following concussion. Design: Cross-Sectional Study Setting: Pediatric Sport Medicine Clinic Participants: Adolescent athletes who recently sustained a concussion (n=44; age=15.4±1.8 years; 39% female) and were seen for care within 14 days (7.3±3.2 days) of their injury, as well as uninjured control participants (n=73; age=15.8±1.3 years; 41% female). All participants completed three single-task and three dual-task tandem gait trials. Outcome Measures: We collected test completion time and cognitive performance for each trial and calculated Pearson correlation coefficients between trials and Intraclass Correlation Coefficients to determine intrasession reliability. We also compared performance between groups, and calculated area under the curve (AUC) values to identify the ability of each trial to distinguish between groups. Results: Both the concussion and control group demonstrated high intrasession reliability between tandem gait trials under single (R ≥ 0.82; ICC≥ 0.93) and dual-task conditions (R ≥ 0.79; ICC≥ 0.92). The greatest group classification values were obtained from the second single-task trial (AUC = 0.89) and first dual-task trial (AUC = 0.83). Test completion time provided excellent between-group discrimination in single-task and dual-task conditions. However, cognitive performance during dual-task trials demonstrated only marginally significant clinical utility (AUC ≤ 0.67). Conclusion: Tandem gait assessments may only require two trials under single-task and one trial under dual-task conditions to effectively discriminate between concussion and control groups. This approach may improve the feasibility (time requirement) of the test, while maintaining excellent discriminatory ability.

scholarly journals Tandem Gait Test-Retest Reliability Among Healthy Child and Adolescent Athletes

2019 ◽  
Vol 54 (12) ◽  
pp. 1254-1259 ◽  
Author(s):  
David R. Howell ◽  
Anna N. Brilliant ◽  
William P. Meehan
Keyword(s):  
Dual Task ◽  
Healthy Child ◽  
Outcome Measure ◽  
Child And Adolescent ◽  
Adolescent Athletes ◽  
Single Task ◽  
Retest Reliability ◽  
Task Conditions ◽  
Test Retest Reliability ◽  
Tandem Gait

Context The tandem gait test is a method for assessing dynamic postural control and part of the Sport Concussion Assessment Tool, versions 3 and 5. However, its reliability among child and adolescent athletes has yet to be established. Objective To examine the test-retest reliability of the single-task and dual-task tandem gait test among healthy child and adolescent athletes. Design Descriptive laboratory study. Setting Sports injury-prevention center. Patients or Other Participants Uninjured and healthy athletes between the ages of 9 and 18 years. Intervention(s) Tandem gait measures repeated 3 times across the period of approximately 1 month. Main Outcome Measure(s) Participants completed the tandem gait test under single-task and dual-task (ie, while simultaneously executing a cognitive task) conditions. Our primary outcome measure was completion time during the single-task and dual-task conditions. We also assessed cognitive accuracy and response rate while participants completed the dual-task tandem gait test. Results Thirty-two child and adolescent athletes completed the study (mean age = 14.3 ± 2.4 years; females = 16). Single-task tandem gait times were similar across the 3 testing sessions (14.4 ± 4.8, 13.5 ± 4.2, and 13.8 ± 4.8 seconds; P = .45). Dual-task tandem gait times steadily improved across the test timeline (18.6 ± 6.9, 16.6 ± 4.5, and 15.8 ± 4.7 seconds; P = .02). Bivariate correlations indicated moderately high to high agreement from test 1 to test 2 (single-task r = .627; dual-task r = 0.655) and from test 2 to test 3 (single-task r = 0.852; dual-task r = 0.775). Both the single-task (intraclass correlation coefficient; ICC [3,1] = 0.86; 95% confidence interval [CI] = 0.73, 0.93) and dual-task (ICC [3,1] = 0.84; 95% CI = 0.69, 0.92) conditions demonstrated high reliability across testing sessions. Conclusions Tandem gait outcome measures demonstrated high test-retest reliability in both the single- and dual-task conditions. The overall reliability was within the acceptable range for clinical practice, but improvements across tests suggested a moderate practice effect. Tandem gait represents a reliable, dynamic, postural-control test that requires minimal space, cost, and time.

Effects of Concurrent Manual Task Performance on Connected Speech Acoustics in Individuals With Parkinson Disease

2019 ◽  
Vol 62 (7) ◽  
pp. 2099-2117 ◽  
Author(s):  
Jason A. Whitfield ◽  
Zoe Kriegel ◽  
Adam M. Fullenkamp ◽  
Daryush D. Mehta
Keyword(s):  
Task Performance ◽  
Speech Production ◽  
Dual Task ◽  
Motor Task ◽  
Task Condition ◽  
Connected Speech ◽  
Speech Acoustics ◽  
Single Task ◽  
Manual Task ◽  
Task Conditions

Purpose Prior investigations suggest that simultaneous performance of more than 1 motor-oriented task may exacerbate speech motor deficits in individuals with Parkinson disease (PD). The purpose of the current investigation was to examine the extent to which performing a low-demand manual task affected the connected speech in individuals with and without PD. Method Individuals with PD and neurologically healthy controls performed speech tasks (reading and extemporaneous speech tasks) and an oscillatory manual task (a counterclockwise circle-drawing task) in isolation (single-task condition) and concurrently (dual-task condition). Results Relative to speech task performance, no changes in speech acoustics were observed for either group when the low-demand motor task was performed with the concurrent reading tasks. Speakers with PD exhibited a significant decrease in pause duration between the single-task (speech only) and dual-task conditions for the extemporaneous speech task, whereas control participants did not exhibit changes in any speech production variable between the single- and dual-task conditions. Conclusions Overall, there were little to no changes in speech production when a low-demand oscillatory motor task was performed with concurrent reading. For the extemporaneous task, however, individuals with PD exhibited significant changes when the speech and manual tasks were performed concurrently, a pattern that was not observed for control speakers. Supplemental Material https://doi.org/10.23641/asha.8637008

Effects of cognitive and physical loads on dynamic and static balance of older adults under single, dual and multi-task conditions

2019 ◽  
Author(s):  
Hamid Allahverdipour ◽  
Iman Dianat ◽  
Galavizh Mameh ◽  
mohammad Asghari Jafarabadi
Keyword(s):  
Older Adults ◽  
Dual Task ◽  
Cognitive Task ◽  
Dynamic Balance ◽  
The Elderly ◽  
Static Balance ◽  
Timed Up And Go ◽  
Task Conditions ◽  
And Control ◽  
Single Versus

Abstract Background: The aim of this study was to evaluate the effects of cognitive and physical loads on dynamic and static balance of older adults under single, dual and multi-task conditions. Methods: The effects of single versus combined (dual-task and multi-task) cognitive (to speak out the name of the weekdays in a reverse order) and physical (with three levels including handling weights of 1kg, 2kg and 3kg in each hand) loads on dynamic and static balance of 42 older adults (21 males and 21 females), aged ≥ 60 years were studied. Dynamic and static balance measures were evaluated using the Timed Up and Go (TUG) and stabilometer (sway index) tests, respectively. Results: The TUG speed of female participants was generally slower than that of male participants. Cognitive task influenced the participants’ dynamic balance during the dual-task conditions, while the static balance was not affected in this phase. The dynamic and static balance measures were more influenced when performing the multi-tasks than when doing the dual-tasks. The effects of various levels of physical demand on the dynamic balance varied greatly under dual- and multi-task conditions. Conclusions: The findings add to the understanding of the factors influencing the elderly balance and control under cognitive and physical functioning.

Effects of Cognitive and Physical Loads on Dynamic and Static Balance Performance of Healthy Older Adults Under Single-, Dual-, and Multi-task Conditions

2020 ◽  
pp. 001872082092462
Author(s):  
Hamid Allahverdipour ◽  
Iman Dianat ◽  
Galavizh Mameh ◽  
Mohammad Asghari Jafarabadi
Keyword(s):  
Older Adults ◽  
Dual Task ◽  
Dynamic Balance ◽  
Static Balance ◽  
Balance Performance ◽  
Timed Up And Go ◽  
Healthy Older Adults ◽  
Physical Task ◽  
Task Conditions ◽  
And Control

Objective The aim of this study is to examine the effects of cognitive and physical loads on dynamic and static balance performance of healthy older adults under single-, dual-, and multi-task conditions. Background Previous studies on postural control in older adults have generally used dual-task methodology, whereas less attention has been paid to multi-task performance, despite its importance in many daily and occupational activities. Method The effects of single versus combined (dual-task and multi-task) cognitive (to speak out the name of the weekdays in a reverse order) and physical (with three levels including handling weights of 1, 2, and 3 kg in each hand) loads on dynamic and static balance performance of 42 older adults (21 males and 21 females) aged ≥60 years were examined. Dynamic and static balance measures were evaluated using the Timed Up and Go (TUG) and stabilometer (sway index) tests, respectively. Results The TUG speed of female participants was generally slower than that of male participants. Age had no effect on balance performance measures. Under dual-task conditions, cognitive load decreased the dynamic balance performance, while the physical task levels had no effect. The dual-task conditions had no impact on the static balance performance. The effects of cognitive and physical loads on dynamic balance performance varied under dual- and multi-task conditions. Conclusion The findings highlight differences between dual- and multi-task protocols and add to the understanding of balance performance in older adults under cognitive and physical loads. Application The present study highlights differences between dual- and multi-task methodologies that need to be considered in future studies of balance and control in older adults.

The Relation between the Type A Behavior Pattern, Pacing, and Subjective Workload under Single-and Dual-Task Conditions

1985 ◽  
Vol 27 (6) ◽  
pp. 675-680 ◽  
Author(s):  
Diane Damos
Keyword(s):  
Dual Task ◽  
Significant Interaction ◽  
Behavior Pattern ◽  
Type A ◽  
Type A Behavior ◽  
Type B ◽  
Type A Behavior Pattern ◽  
Single Task ◽  
Task Conditions ◽  
And Task

Twenty Type A and 20 Type B subjects performed two discrete tasks alone and together. Half of the subjects performed paced versions of both tasks; half, unpaced versions. Workload ratings were obtained for all subjects under single-and dual-task conditions using eight bipolar adjective scales. Under single-task conditions there was a significant interaction between behavior pattern and pacing on one of the tasks. This interaction indicated that Type A subjects responded more rapidly under unpaced conditions than did Type B subjects, although there was little difference between the groups under paced conditions. Under dualtask conditions, Type A subjects responded more rapidly than did Type B subjects regardless of pacing. There was one significant interaction between behavior pattern and task on one of the workload scales.

Single-Task and Dual-Task Tandem Gait Performance Across Clinical Concussion Milestones in Collegiate Student-Athletes

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jessie R. Oldham ◽  
David R. Howell ◽  
Christopher A. Knight ◽  
Jeremy R. Crenshaw ◽  
Thomas A. Buckley
Keyword(s):  
Dual Task ◽  
Student Athletes ◽  
Single Task ◽  
Gait Performance ◽  
Tandem Gait

scholarly journals Timing of reactive stepping among individuals with sub-acute stroke: effects of ‘single-task’ and ‘dual-task’ conditions

Heliyon ◽  
2016 ◽  
Vol 2 (10) ◽  
pp. e00186 ◽  
Author(s):  
Alison Schinkel-Ivy ◽  
Andrew H. Huntley ◽  
Elizabeth L. Inness ◽  
Avril Mansfield
Keyword(s):  
Acute Stroke ◽  
Dual Task ◽  
Single Task ◽  
Task Conditions ◽  
Reactive Stepping

Effects of Category and Rhyme Decisions on Sentence Production

2002 ◽  
Vol 45 (5) ◽  
pp. 844-857 ◽  
Author(s):  
Hans-Georg Bosshardt ◽  
Waltraud Ballmer ◽  
Luc F. de Nil
Keyword(s):  
Dual Task ◽  
Speech Rate ◽  
Sentence Production ◽  
Experimental Conditions ◽  
Sentence Generation ◽  
Secondary Tasks ◽  
Single Task ◽  
Dependent Variables ◽  
Dual Versus ◽  
Task Conditions

The aim of the present experiment was to investigate differences between persons who stutter and persons who do not stutter during the production of sentences in a single task versus two dual-task conditions. Participants were required to form a sentence containing 2 unrelated nouns. In dual-task conditions, rhyme and category decisions were used as secondary tasks. The results for 14 adults who stutter and 16 adults who do not stutter are reported. Dependent variables were the number of correct rhyme and category decisions, decision latencies, length, number of propositions, sentence latency, speech rate of sentences, disfluencies, and stuttering rates. The results indicated that both groups reduced the average number of correct rhyme and category decisions when this task was performed concurrently with sentence generation and production. Similarly, the 2 groups of participants did not differ with respect to the correctness and latency of their decisions. Under single-task conditions the sentences of both groups had a comparable number of propositions. But under dual- as compared with singletask conditions persons who stutter significantly reduced the number of propositions whereas persons who do not stutter did not show a significant dual- versus single-task contrast. Experimental conditions did not significantly influence stuttering rates. These results suggest that persons who stutter require more processing capacity for sentence generation and articulation than persons who do not stutter and that both groups keep stuttering rates at a constant level by adjusting the number of propositional units of their linguistic productions. The results support the view that the organization of the speech-production system of persons who stutter makes it more vulnerable to interference from concurrent attention-demanding semantic tasks.

scholarly journals Training of Balance Under Single- and Dual-Task Conditions in Older Adults With Balance Impairment

2006 ◽  
Vol 86 (2) ◽  
pp. 269-281 ◽  
Author(s):  
Patima Silsupadol ◽  
Ka-Chun Siu ◽  
Anne Shumway-Cook ◽  
Marjorie H Woollacott
Keyword(s):  
Older Adults ◽  
Case Report ◽  
Dual Task ◽  
Balance Training ◽  
Single Task ◽  
Balance Impairment ◽  
Instructional Set ◽  
Task Training ◽  
Dual Task Training ◽  
Task Conditions

Background and Purpose. Traditionally, rehabilitation programs emphasize training balance under single-task conditions to improve balance and reduce risk for falls. The purpose of this case report is to describe 3 balance training approaches in older adults with impaired balance. Case Descriptions. Three patients were randomly assigned to 1 of 3 interventions: (1) single-task balance training, (2) dual-task training under a fixed-priority instructional set, and (3) dual-task training under a variable-priority instructional set. Outcomes. The patients who received balance training under dual-task conditions showed dual-task training benefits; these training benefits were maintained for 3 months. The patient who received variable-priority training showed improvement on novel dual tasks. Discussion. Older adults may be able to improve their balance under dual-task conditions only following specific types of balance training. This case report gives insight on how this intervention might be combined with more traditional physical therapy intervention. [Silsupadol P, Siu KC, Shumway-Cook A, Woollacott MH. Training of balance under single- and dual-task conditions in older adults with balance impairment. Phys Ther. 2006;86:269–281.]

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