Does Combined Baseline Cognitive Function And Motor Control Correlate With Post-concussion Recovery Time?

Combined cognitive function and motor control (dual-tasking) is essential to peak performance during sports. Individuals must effectively filter nonessential information to complete the desired movement outcome. Individuals experience impaired dual-task (DT) ability post-concussion. However, it is unknown if baseline DT ability, assessed via DT tandem gait (TG), relates to post-concussion recovery time. Combined cognitive function and motor control are modifiable factors that may improve concussion recovery. PURPOSE: To determine if baseline single-task (ST) and DT TG are associated with post-concussion recovery time. METHODS: Thirty-five Division I athletes (19 males, 16 females) with a diagnosed concussion completed a timed TG protocol during pre-season baseline testing by walking heel-to-toe down a 3 m line, turning 180 degrees, and returning to the start as fast as possible. Participants completed 3 ST (walking) and DT (walking with a cognitive task) TG trials. The cognitive task consisted of serial subtraction by 7’s, spelling words backward, and reciting months in reverse order. Independent variables included DT TG time, ST TG time, and DT cost for TG time, cognitive accuracy, and correct response rate. We calculated DT cost as: [(ST - DT)/ST]*100. Dependent variables included days until asymptomatic (the day of concussion injury to the day of symptom resolution testing) and days to return to play (RTP) (the day of concussion injury to the day the athlete was cleared for full participation). We ran separate univariate linear regressions with TG outcomes as predictors of asymptomatic and RTP (alpha = 0.05). RESULTS: Baseline DT cost for TG time (mean = 46.3 ± 29.6%) is significantly associated with days until RTP (p = 0.012, R2 = 0.176, β = 0.11). Athletes with greater DT cost for TG time experienced longer RTP times. All other regressions were non-significant (p-range = 0.093-0.921, R2-range = <0.001-0.083). CONCLUSION: Athletes with poorer cognitive and motor control performance at baseline had longer recoveries post-concussion. Athletes with greater DT costs for TG time may benefit from targeted DT interventions.