The utility of instrumented dual-task gait and tablet-based neurocognitive measurements after concussion.

ABSTRACT

OBJECTIVES: Quantitative and non-invasive measurements acquired by neurocognitive or gait evaluations are useful concussion management components. Emerging technology has allowed for the development of portable and objective tests which may be potentially useful across many settings where evaluations take place. Our aim was to examine the association between instrumented dual-task gait and tablet-based neurocognitive outcome variables with an acute concussion. DESIGN: A total of 59 collegiate athletes were identified and tested within 5days of concussion (n=18, 50% female, 20±1years of age) or as a part of a baseline examination (n=41, 29% female, 19±1years of age). METHODS: Participants completed an instrumented dual-task gait evaluation and a tablet-based neurocognitive evaluation. Outcome variables were compared with t-tests, and a multivariable logistic regression model was constructed to identify the association between the presence of a concussion and test performance. RESULTS: Compared with controls, participants with concussion reported significantly more severe symptoms (PCSS=19.1±15.2 vs. 4.1±6.3; p<0.001), walked significantly slower during dual-task conditions (87.7±10.4cm/s vs. 98.1±15.4cm/s; p=0.01), and responded with significantly slower simple reaction times (305.2±32.4ms vs. 275.4±22.1ms; p<0.001). After adjusting for the effect of potential confounding variables, these three variables (more severe symptoms, slower walking speed, and slower reaction time) remained independently associated with concussion (adjusted odds ratios=1.181, 0.916, and 1.043, respectively). CONCLUSIONS: Relatively simple quantitative measurements of dual-task gait and reaction time may be useful and portable clinical tests in the multifaceted assessment of concussion.