The diagnostic and prognostic utility of the dual-task tandem gait test for pediatric concussion

Autor: Julie C. Wilson, David R. Howell, Katie A. Van Deventer, Gregory A. Walker, Corrine N. Seehusen
Rok vydání: 2021
Předmět:
Male
Balance
medicine.medical_specialty
Time Factors
Adolescent
Tandem gait
Postural stability
Poison control
Physical Therapy
Sports Therapy and Rehabilitation
Neuropsychological Tests
Sensitivity and Specificity
lcsh:GV557-1198.995
03 medical and health sciences
0302 clinical medicine
Task Performance and Analysis
Concussion
Injury prevention
Confidence Intervals
Humans
Medicine
Orthopedics and Sports Medicine
030212 general & internal medicine
Mild traumatic brain injury
lcsh:Sports medicine
Child
Postural Balance
Brain Concussion
Retrospective Studies
Balance (ability)
lcsh:Sports
Concussion management
Post-Concussion Syndrome
business.industry
030229 sport sciences
Prognosis
medicine.disease
Cognitive test
Tandem gait test
Case-Control Studies
Physical therapy
Original Article
Female
Symptom Assessment
Gait Analysis
lcsh:RC1200-1245
business
human activities
Zdroj: Journal of Sport and Health Science, Vol 10, Iss 2, Pp 131-137 (2021)
Journal of Sport and Health Science
ISSN: 2095-2546
Popis: Highlights • Single/dual-task tandem gait performance after concussion was slower than in controls. • Tandem gait cut-points provided > 80% accuracy between concussion and control groups. • Dual-task tandem gait test performance may provide some prognostic value.
Background The tandem gait test has gained interest recently for assessment of concussion recovery. The purpose of our study was to determine the prognostic and diagnostic use of the single- and dual-task tandem gait test, alongside other clinical measures, within 10 days of pediatric concussion. Methods We assessed 126 patients post-concussion (6.3 ± 2.3 days post-injury, mean ± SD) at a pediatric sports medicine clinic and compared them to 58 healthy controls (age: 15.6 ± 1.3 years; 43% female). We also compared the 31 patients with concussion who developed persistent post-concussion symptoms (PPCS) (age = 14.9 ± 2.0 years; 48% female) to the 81 patients with concussion who did not develop PPCS following the initial assessment (age: 14.1 ± 3.0 years; 41% female). All subjects completed a test battery, and concussion patients were monitored until they experienced concussion-symptom resolution. The test battery included tandem gait (single-task, dual-task (performing tandem gait while concurrently completing a cognitive test) conditions), modified Balance Error Scoring System (mBESS), and concussion symptom assessment (Health and Behavior Inventory). We defined PPCS as symptom resolution time > 28 days post-concussion for the concussion group. Measurement outcomes included tandem gait time (single- and dual-task), dual-task cognitive accuracy, mBESS errors (single/double/tandem stances), and symptom severity. Results The concussion group completed the single-task (mean difference = 9.1 s, 95% confidential interval (95%CI): 6.1–12.1) and dual-task (mean difference = 12.7 s, 95%CI: 8.7–16.8) tandem gait test more slowly than the control group. Compared to those who recovered within 28 days of concussion, the PPCS group had slower dual-task tandem gait test times (mean difference = 7.9 s, 95%CI: 2.0–13.9), made more tandem-stance mBESS errors (mean difference = 1.3 errors, 95%CI: 0.2–2.3), and reported more severe symptoms (mean difference = 26.6 Health and Behavior Inventory rating, 95%CI: 21.1–32.6). Conclusion Worse dual-task tandem gait test time and mBESS tandem stance performance predicted PPCS in pediatric patients evaluated within 10 days of concussion. Tandem gait assessments may provide valuable information augmenting common clinical practices for concussion management.
Graphical abstract Image, graphical abstract
Databáze: OpenAIRE
Externí odkaz: