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J Sci Med Sport. 2017 Jul;20(7):622-626. doi: 10.1016/j.jsams.2016.11.020. Epub 2017 Jan 24.

Single-task and dual-task tandem gait test performance after concussion.

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The Micheli Center for Sports Injury Prevention, USA; Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, USA; Brain Injury Center, Boston Children's Hospital, USA.
Motion Analysis Laboratory, Department of Human Physiology, University of Oregon, USA.
Motion Analysis Laboratory, Department of Human Physiology, University of Oregon, USA. Electronic address:



To compare single-task and dual-task tandem gait test performance between athletes after concussion with controls on observer-timed, spatio-temporal, and center-of-mass (COM) balance control measurements.


Ten participants (19.0±5.5years) were prospectively identified and completed a tandem gait test protocol within 72h of concussion and again 1 week, 2 weeks, 1 month, and 2 months post-injury. Seven uninjured controls (20.0±4.5years) completed the same protocol in similar time increments.


Tandem gait test trials were performed with (dual-task) and without (single-task) concurrently performing a cognitive test as whole-body motion analysis was performed. Outcome variables included test completion time, average tandem gait velocity, cadence, and whole-body COM frontal plane displacement.


Concussion participants took significantly longer to complete the dual-task tandem gait test than controls throughout the first 2 weeks post-injury (mean time=16.4 [95% CI: 13.4-19.4] vs. 10.1 [95% CI: 6.4-13.7] seconds; p=0.03). Single-task tandem gait times were significantly lower 72h post-injury (p=0.04). Dual-task cadence was significantly lower for concussion participants than controls (89.5 [95% CI: 68.6-110.4] vs. 127.0 [95% CI: 97.4-156.6] steps/minute; p=0.04). Moderately-high to high correlations between tandem gait test time and whole-body COM medial-lateral displacement were detected at each time point during dual-task gait (rs=0.70-0.93; p=0.03-0.001).


Adding a cognitive task during the tandem gait test resulted in longer detectable deficits post-concussion compared to the traditional single-task tandem gait test. As a clinical tool to assess dynamic motor function, tandem gait may assist with return to sport decisions after concussion.


Balance; Concussion; Dual-task; Locomotion; Mild traumatic brain injury; Tandem gait

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