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J Sci Med Sport. 2013 May;16(3):190-4. doi: 10.1016/j.jsams.2012.09.007. Epub 2012 Oct 23.

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

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Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.



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


Repeated measures.


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.


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.


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.

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