Utility Of Backwards Tandem Gait For Post-concussion Assessment

Previous literature has focused on utilizing tandem gait as an assessment to evaluate athletes post-concussion with growing evidence of using a dual-task protocol to further elicit deficits in postural control post-concussion. Further, regular backwards gait is being increasingly studied as an assessment of balance. Purpose: To investigate how experiencing a concussion and dual-tasking affects performance of athletes during forward and backward tandem gait. Methods: 8 female and 9 male D1-athletes who experienced a concussion (Age, 20.3 ± 1.7 years) and 17 age- and sex-matched athletes who did not experience a concussion (Age, 19.8 ± 1.6 years) did tandem gait with no shoes. Tandem gait was done in forward and backward directions under single- and dual-task conditions 3 times each. Cognitive tasks during dual-tasking consisted of reciting the months backwards, counting backwards by 6 or 7 from a certain number, or spelling 5-letter words backwards. Best time of the 3 trials was analyzed using a two-way mixed ANOVA for forward and backward tandem gait separately. Results: For forward tandem gait, no significant interaction (P = 0.233) or group main effect (P = 0.173) were observed (Table 1). For backward tandem gait, there was no significant interaction (P = 0.233) though individuals who experienced a concussion took significantly longer time while dual-tasking (P = 0.034; Table 1). A trend towards significance for the group main effect showed that individuals who experienced a concussion seemed to take longer time during backward gait (P = 0.063; Table 1). For both forward and backward tandem gait, significant task main effect showed that participants took longer time to complete the task while dual-tasking (both P < 0.001; Table 1). Conclusion: Pilot data seems to suggest that backward tandem gait particularly while dual-tasking could be more effective in identifying postural-control deficits in individuals who experienced a concussion compared to forward tandem gait. - Table 1. Mean ± SD of dependent variables across both the groups and tasks Concussion Group Control Group Single Task Dual Task Single Task Dual Task Forward Tandem Gait Best Time (s) 18.32 (4.08) 24.17 (6.36) 16.77 (4.59) 21.03 (5.71) Backward Tandem Gait Best Time (s) 23.22 (7.34) 28.19 (6.40) 20.25 (4.71) 23.54 (5.78)