Balance and cognitive performance during a dual-task: preliminary implications for use in concussion assessment

Abstract

Objectives: To determine the reliability and effects of a dual-task paradigm on balance and cognitive function compared to a single-task paradigm.

Design: Repeated measures.

Methods: Healthy participants (n=23) completed a variation of the Sensory Organization Test and the incongruent Stroop test individually (single-task) and concurrently (dual-task) during two testing sessions.

Results: The Sensory Organization Test and incongruent Stroop test had moderate to high reliability (1.00>ICC2,k>0.60) under the dual-task conditions. Reaction time was significantly longer (t21=-2.54, p=0.019) under the dual-task conditions, while balance scores under one of the four conditions of the Sensory Organization Test (sway floor/fixed wall) were statistically better (t22=-3.03, p=0.006) under the dual-task conditions. However, this difference in balance scores may not be clinically meaningful.

Conclusions: These findings illustrate that the Sensory Organization Test and incongruent Stroop task can be reliably incorporated into a dual-task assessment paradigm. The slowed reaction time under the dual-task paradigm indicates that the dual-task provided an additional cost to cognitive function. Dual-task concussion assessment paradigms involving these two tasks are psychometrically appropriate as well as more representative of actual sporting situations. However, more research should be conducted in a concussed population to further validate this claim.