Effects of a Single-Task Versus a Dual-Task Paradigm on Cognition and Balance in Healthy Subjects

in Journal of Sport Rehabilitation
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Context:

Recent evidence has revealed deficiencies in the ability to divide attention after concussion.

Objective:

To examine the effects of a single vs a dual task on cognition and balance in healthy subjects and to examine reliability of 2 dual-task paradigms while examining the overall feasibility of the tasks.

Design:

Pretest–posttest experimental design.

Setting:

Sports medicine research laboratory.

Patients:

30 healthy, recreationally active college students.

Intervention:

Subjects performed balance and cognitive tasks under the single- and dual-task conditions during 2 test sessions 14 d apart.

Main Outcome Measures:

The procedural reaction-time (PRT) test of the Automated Neuropsychological Assessment Metrics (eyes-closed tasks) and an adapted Procedural Auditory Task (PAT; eyes-open tasks) were used to assess cognition. The NeuroCom Sensory Organization Test (SOT) and the Balance Error Scoring System (BESS) were used to assess balance performance. Five 2-way, within-subject ANOVAs and a paired-samples t test were used to analyze the data. ICCs were used to assess reliability across 2 test sessions.

Results:

On the SOT, performance significantly improved between test sessions (F1,29 = 35.695, P < .001) and from the single to the dual task (F1,29 = 9.604, P = .004). On the PRT, performance significantly improved between test sessions (F1,29 = 57.252, P < .001) and from the single to the dual task (F1,29 = 7.673, P = .010). No differences were seen on the BESS and the PAT. Reliability across test sessions ranged from moderate to poor for outcome measure.

Conclusions:

The BESS appears to be a more reliable and functional tool in dual-task conditions as a result of its increased reliability and clinical applicability. In addition, the BESS is more readily available to clinicians than the SOT.

Ross, Prentice, and Shields are with the Dept of Exercise and Sport Science; Register-Mihalik, Mihalik, and Guskiewicz, the Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center; and McCulloch, the Div of Physical Therapy, University of North Carolina, Chapel Hill, NC.