Practice Effects In Three Consecutive Pre-season Tandem Gait Tests In Division I Athletes

In compliance with collegiate athletic regulations, athletes must undergo annual baseline testing, in the event a concussion is sustained. Tandem gait (TG) is a recommended aspect of the baseline and post-concussion postural control assessment. Due to this repeated testing, athletes may be subject to practice effects. PURPOSE: Examine differences in TG best performance from collegiate athletes during three consecutive athletic pre-season baselines under both single-task (ST) and dual-task (DT) conditions. METHODS: 50 collegiate athletes (30 female, 20 male; avg. age 2022: 20 ± 1.48 yrs, 2023: 21 ± 1.50 yrs, 2024: 22 ± 1.01 yrs) completed a standardized TG task prior to three consecutive athletic seasons (average time between tests 2023: 0.98 yrs, 2024: 1.01 yrs). Athletes were excluded if they sustained a concussion during the time frame of the study (2022 to 2024). Athletes were deemed healthy by a sports medicine physician prior to completion of the TG baseline. For the TG task, athletes walked in a heel-to-toe pattern along a 3-meter line for 3 pseudorandomized trials of single-task (ST) and 3 dual-task (DT; serial seven subtraction) conditions. The fastest trial of each TG condition (ST and DT) by year were analyzed using two repeated measures analysis of variance (ANOVA). Follow-up post-hoc analyses were conducted when a significant time effect was detected. RESULTS: For ST, there was no difference (F = 0.14, df = 98, p = 0.87) seen in best performance across years (2022 = 10.83 ± 3.17 s, 2023 = 11.07 ± 3.62 s, 2024 = 10.89 ± 1.90 s). Conversely, there was a main effect for year during DT (F = 6.17, df = 98.00, p = 0.003). A Tukey Post-hoc test determined that between the years of 2022 (15.99 ± 5.11 s) to 2023 (15.39 ± 3.69 s; p = 0.73), and 2023 to 2024 (13.81 ± 2.45 s; p = 0.12) there was no difference in mean performance for DT. A significant difference was found in DT performance between the 2022 and 2024 seasons (p = 0.02). CONCLUSION: ST fastest times do not have a learning effect across multiple years; however, DT has a learning effect. This effect appears to be isolated to a span of two years (i.e. 2022 to 2024) and may be related to the athlete’s familiarity with the test. Alternative testing may be needed in order to reduce practice effects, and maintain diagnostic validity post-concussion.