Context: Gait termination time (GTT) has been used to predict falls in older adults but has not been explored in the sport rehabilitation setting. The incorporation of a concurrent cognitive task as a complex measure of gait in this clinical population could lead to better health-related outcomes. Objective: To compare the effect of planned and unplanned gait termination with and without a concurrent cognitive task on reaction time (RT), gait velocity, and GTT. Design: Cross-sectional. Setting: Laboratory. Participants: Twenty young adults (females 60.0%, age 20.1 [0.9] y, height 169.5 [8.8] cm, mass 67.4 [10.8] kg). Intervention: Participants completed 6 planned and 6 unplanned gait termination trials on an instrumented gait mat with and without a cognitive task. Main Outcome Measures: The authors measured RT (s), gait velocity (m/s), GTT (s), and normalized GTT (s2/m). A 2 (motor) × 2 (cognitive) repeated-measures analysis of variance (α = .05) was used; significant interaction effects were explored using Bonferroni-corrected t tests (α < .008). Results: Participants walked more slowly during dual-task trials compared with single-task trials (F 1,19 = 4.401, P = .050). Participants walked significantly more slowly with a cognitive task during planned (P < .001, mean difference = −0.184 m/s, 95% CI, −0.256 to −0.111) and unplanned (P = .001, mean difference = −0.111 m/s, 95% CI, −0.173 to −0.050) gait termination. Participants walked significantly more slowly (P < .001, mean difference = −0.142 m/s, 95% CI, −0.210 to −0.075) when performing the most difficult task, unplanned termination with a cognitive task, than when performing the least difficult task, planned termination with no cognitive task. We observed a cognitive task main effect such that adding a cognitive task increased RT (F 1,19 = 16.375, P = .001, mean difference = −0.118 s, 95% CI, −0.178 to −0.057) and slowed normalized GTT (F 1,19 = 5.655, P = .028, mean difference = −0.167 s2/m, 95% CI, −0.314 to −0.020). Conclusions: Overall, participants displayed more conservative gait strategies and slower RT, normalized GTT, and gait velocity as task difficulty increased. More investigation is needed to truly understand the clinical meaningfulness of these measures in athletic injuries.
Rachel S. Johnson, Kendall H. Scott and Robert C. Lynall
Maria K. Talarico, Robert C. Lynall, Timothy C. Mauntel, Erin B. Wasserman, Darin A. Padua and Jason P. Mihalik
Although single-leg squats are a common dynamic balance clinical assessment, little is known about the relationship between parameters that influence squat movement and postural control performance. The objective of this study was to determine the relationships between squat parameters (speed and depth) and postural control under single task and dual task. A total of 30 healthy college students performed single-leg squats under single task and dual task with Stroop. Random-intercepts generalized linear mixed models determined the effect of squat parameters on center of pressure (CoP) parameters. For each 1-cm·s−1 increase in squat speed, sway range (mediolateral: β = −0.03; anteroposterior: β = −0.05) and area (β = −0.25) decreased, whereas sway speed (mediolateral: β = 0.05; anteroposterior: β = 0.29; total: β = 0.29) increased. For each 1-cm increase in squat depth, sway range (mediolateral: β = 0.05; anteroposterior: β = 0.20) and area (β = 0.72) increased, whereas sway speed (anteroposterior: β = −0.14; total: β = −0.14) decreased. Compared with single task, the association between total and anteroposterior sway speed and squat speed was stronger under dual task. Clinicians and researchers should consider monitoring squat speed and depth when assessing dynamic balance during single-leg squats, as these parameters influence postural control, especially under dual task.
Jason P. Mihalik, Elizabeth F. Teel, Robert C. Lynall and Erin B. Wasserman
In equipment-heavy sports, there is a growing need to evaluate players in the condition in which they participate. However, the psychometric properties of the Balance Error Scoring System (BESS) while wearing skates remains unknown. Seventy-four adolescent male hockey players completed the BESS with and without skates. A subset was reevaluated at the conclusion of the season. The BESS while wearing skates resulted in a mean of 15 more total errors than the traditional administration (t73 = 14.94, p < .001; ES = 1.95) and demonstrated low test-retest reliability. The BESS should be administered in the traditional manner (without skates).