Clinical Feasibility and Utility of a Dual-Task Tandem Gait Protocol for Pediatric Concussion Management.

Clinical management of sport-related concussion requires the assessment of various factors, including motor performance. The tandem gait test, a measure of postinjury motor performance, has demonstrated clinical utility but is limited by time availability and test uniformity. To assess intrasession...

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Publicado en:Journal of Athletic Training (KnowledgeWorks Global, Ltd) Vol. 58; no. 2; pp. 106 - 112
Autores principales: Wingerson, Mathew J., Seehusen, Corrine N., Walker, Gregory, Wilson, Julie C., Howell, David R.
Formato: research tables/charts Journal Article
Publicado: KnowledgeWorks Global, Ltd Feb2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2023
      vid: 58
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      pub: KnowledgeWorks Global, Ltd
      place: Richmond, Virginia
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        atl: Clinical Feasibility and Utility of a Dual-Task Tandem Gait Protocol for Pediatric Concussion Management.
      aug:
        au:
          Wingerson, Mathew J.
          Seehusen, Corrine N.
          Walker, Gregory
          Wilson, Julie C.
          Howell, David R.
        affil: Sports Medicine Center, Children's Hospital Colorado, Aurora
      sug:
        subj:
          Brain Concussion Prevention and Control
          Decision Making, Clinical
          Task Performance and Analysis
          Gait Analysis
          Pediatric Care
          Clinical Assessment Tools
          Instrument Validation
          Human
          Cross Sectional Studies
          Male
          Female
          Psychometrics
          Descriptive Statistics
          Pearson's Correlation Coefficient
          Intraclass Correlation Coefficient
          ROC Curve
          Reliability
          Protocols
          Athletes
          Sensitivity and Specificity
          Child
          Funding Source
          Motor Skills
          Validation Studies
          Cognition Evaluation
          Discriminant Validity
          Child: 6-12 years
          Male
          Female
      ab: Clinical management of sport-related concussion requires the assessment of various factors, including motor performance. The tandem gait test, a measure of postinjury motor performance, has demonstrated clinical utility but is limited by time availability and test uniformity. To assess intrasession reliability between tandem gait test trials and determine the number of trials necessary for optimal utility and feasibility in clinical decision-making after concussion. Cross-sectional study. Pediatric sport medicine clinic. Adolescent athletes who recently sustained a concussion (n = 44; age = 15.4 ± 1.8 years; 39% females) and were seen for care within 14 days (7.3 ± 3.2 days) of their injury as well as uninjured control participants (n = 73; age = 15.8 ± 1.3 years; 41% females). All individuals completed 3 single-task and 3 dual-task tandem gait trials. We collected test completion time and cognitive performance for each trial and calculated Pearson correlation coefficients between trials and intraclass correlation coefficients (ICCs) to determine intrasession reliability. We also compared performance between groups and calculated area under the curve (AUC) values to identify the ability of each trial to distinguish between groups. Both the concussion and control groups demonstrated high intrasession reliability between tandem gait trials under single- (R ≥ 0.82, ICC ≥ 0.93) and dual- (R ≥ 0.79, ICC ≥ 0.92) task conditions. The greatest group classification values were obtained from the second single-task trial (AUC = 0.89) and first dual-task trial (AUC = 0.83). Test completion time provided excellent between-groups discrimination in single- and dual-task conditions. However, cognitive performance during dual-task trials demonstrated only marginally significant clinical utility (AUC ≤ 0.67). Tandem gait assessments may only require 2 trials under single-task and 1 trial under dual-task conditions to effectively discriminate between concussion and control groups. This approach may improve the feasibility (ie, time requirement) of the test while maintaining excellent discriminatory ability.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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