Dual-Task Effect on Gait Balance Control in Adolescents With Concussion
Dual-Task Effect on Gait Balance Control in Adolescents With Concussion
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DOI：
10.1016/j.apmr.2013.04.015
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发表时间：
2013-08-01
影响因子：
4.3
通讯作者：
Chou, Li-Shan
中科院分区：
文献类型：
--
作者：
Howell, David R.;Osternig, Louis R.;Chou, Li-Shan
目的：前瞻性和纵向研究脑震荡如何影响青少年在单任务和双任务行走期间的步态平衡控制。设计：队列，前瞻性，重复测量设计。设置：运动分析实验室。参与者：确定为脑震荡的青少年（N = 20）与健康对照受试者（N= 20）匹配，并在受伤后2个月内进行5次测试。干预措施：不适用。主要结果测量：步态时间距离参数包括平均步行速度、步长和步宽;全身质心（COM）参数包括内侧/外侧位移和峰值COM内侧/外侧和前部速度;双任务成本，定义为从单任务到双任务条件的百分比变化; Stroop测试准确性。结果：未观察到步长和步长的组间差异。在2个月的测试期间，脑震荡受试者平均步行速度的双任务成本大于对照受试者（组的主效应P= 0.019），前COM峰值速度（组的主效应P= 0.017）和总COM内侧/外侧位移（组的主效应P= 0.013）的双任务成本也是如此。在双任务行走过程中，脑震荡受试者的总COM内侧/外侧位移（组x任务相互作用P=.006）和峰值COM内侧/外侧速度（组的主效应P=.027;任务的主效应P=.01）显著大于对照受试者。受试者脑震荡显着低于准确性比对照组的Stroop测试（组P= 0.004）。结论：研究结果表明，脑震荡影响的能力，青少年在步态控制身体姿势受伤后2个月。此外，双任务范式可以在脑震荡的临床评估和恢复中提供额外的有用信息。Archives of Physical Medicine and Rehabilitation 2013;94：1513-20（C）2013美国康复医学大会
Objective: To prospectively and longitudinally examine how concussion affects gait balance control in adolescents during single- and dual-task walking.Design: Cohort, prospective, repeated-measures design.Setting: Motion analysis laboratory.Participants: Adolescents (N=20) identified as suffering a concussion were matched with healthy control subjects (N=20) and tested 5 times across a 2-month period after injury.Interventions: Not applicable.Main Outcome Measures: Gait temporal-distance parameters included average walking speed, step length, and step width; whole body center of mass (COM) parameters included medial/lateral displacement and peak COM medial/lateral and anterior velocities; dual-task cost, which was defined as percent change from single- to dual-task conditions; and Stroop test accuracy.Results: No between-group differences were observed for step length and step width. The dual-task cost for average walking speed for subjects with concussion was greater than control subjects across the 2-month testing period (main effect of group P=.019), as was the dual-task costs for peak anterior COM velocity (main effect of group P=.017) and total COM medial/lateral displacement (main effect of group P=.013). The total COM medial/lateral displacement (group x task interaction P=.006) and peak COM medial/lateral velocity (main effect of group P=.027; main effect of task P=.01) were significantly greater in subjects with concussion compared with control subjects during dual-task walking. Subjects with concussion were significantly less accurate than controls on the Stroop test (main effect of group P=.004).Conclusions: The findings suggest that concussion affects the ability of adolescents to control body posture during gait up to 2 months after injury. Furthermore, dual-task paradigms may provide additional useful information in the clinical assessment and recovery of concussion. Archives of Physical Medicine and Rehabilitation 2013;94:1513-20 (C) 2013 by the American Congress of Rehabilitation Medicine