, Volume 232, Issue 6, pp 1773-1782

The effect of cognitive task complexity on gait stability in adolescents following concussion

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Concussion has been reported to result in disturbances to motor and cognitive functions. One way to examine these disturbances is through a dual-task assessment. Many secondary cognitive tasks have been proposed as appropriate tools during concussion assessment; however, task complexity has not been compared within a dual-task investigation. The purpose of this study was to prospectively examine how gait balance control was affected by three secondary cognitive tasks of varying complexity following concussion. Forty-six adolescents completed a dual-task walking protocol which included walking without any cognitive task (WALK), walking while completing a single auditory Stroop (SAS), multiple auditory Stroop (MAS), and a question and answer task (Q&A). Those who sustained a concussion (n = 23, mean age 15.4 ± 1.3 years) reported to the laboratory within 72 h of injury and in the following time increments: 1 week, 2 weeks, 1 month, and 2 months post-injury. Twenty-three healthy control subjects (mean age 15.4 ± 1.3 years), individually matched to each concussion subject, completed the same protocol in similar time increments. The concussion group demonstrated greater total center of mass (COM) medial/lateral displacement in the MAS and Q&A conditions compared with the control group. The concussion group also displayed the greatest peak COM anterior velocity in the least complex condition (WALK), and a significant decrease was observed as task complexity increased (SAS > MAS > Q&A). These findings indicate that gait balance control may be affected by task complexity following concussion and represent a way to identify motor recovery following concussion.