Increased Auditory Dual Task Cost During Gait Initiation in Adult Patients With Persistent Concussion Symptoms

IF 3.6 2区医学 Q1 REHABILITATION Archives of physical medicine and rehabilitation Pub Date : 2024-12-01 DOI:10.1016/j.apmr.2024.08.007

Kelsey N. Bryk PhD , Scott Passalugo BS , Li- Shan Chou PhD , Darcy S. Reisman PT, PhD , Jocelyn F. Hafer PhD , Jennifer A. Semrau PhD , Thomas A. Buckley EdD

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Abstract

Objective

To compare dual task cost (DTC) during gait initiation (GI) between a population of patients with persistent concussion symptoms (PCS) and age-matched healthy participants.

Design

Cohort study.

Setting

University research center.

Participants

A cohort sample including 15 participants with PCS (43.9±11.7y, 73.3% female) and 23 age-matched healthy participants (42.1±10.3y, 65.2% female) as controls.

Interventions

Participants were tested on a single occasion where they performed 5 trials of single task and 5 trials of dual task GI with 12-camera motion capture and 3 force plates.

Main Outcome Measures

The dependent variables of interest were the DTC for the center of pressure (COP) displacement and velocity during the anticipatory postural adjustment (APA) phase, the COP-center of mass (COP-COM) separation, and the response accuracy during the auditory cognitive tasks.

Results

There were significant group differences with worse DTC for the PCS participants in anterior (A)/posterior (P) displacement (PCS, −37.5±22.1%; Control, −9.7±39.2%; P=.016, d=0.874), APA medial (M)/lateral (L) velocity (PCS, −34.8±28.8%; Control, −17.0±40.21%; P=.041, d=0.866), and the peak COP-COM separation (PCS, −7.3±6.7%; Control, 0.6±6.5%; P=.023, d=1.200). There were no significant group differences in the APA A/P velocity (PCS, −38.8±33.1%; Control, −19.8±43.9%; P=.094), APA M/L displacement (PCS, −34.8±21.8%; Control, −10.6±25.3%; P=.313), or cognitive task performance (PCS, −2.7±10.8%; Control, −0.2±4.3%; P=.321).

Conclusions

PCS participants had greater (worse) DTC during both the planning and execution of the task, with large effect sizes (d>0.80). PCS participants also used a posture-second strategy whereby attentional resources were inappropriately allocated to the cognitive task. These deficits may challenge a patient's ability to complete activities of daily living and limit their functional independence.

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有持续脑震荡症状的成人患者在步态启动过程中听觉双重任务成本增加。

目的比较持续性脑震荡症状（PCS）患者与年龄匹配的健康参与者在步态启动（GI）过程中的双重任务成本（DTC）：设计：队列研究：地点：大学研究中心：队列样本包括 15 名 PCS 患者（43.9 ± 11.7 岁，73.3% 为女性）和 23 名年龄匹配的对照组患者（42.1 ± 10.3 岁，65.2% 为女性）：主要结果测量：相关因变量为预期姿势调整（APA）阶段压力中心（COP）位移和速度的DTC、COP-质量中心（COP-COM）分离度以及听觉认知任务中的反应准确性：874）、APA M/L 速度（PCS：-34.8 ± 28.8%，对照组：-17.0 ± 40.21%，P=0.041，d= 0.866）和 COP-COM 分离峰值（PCS：-7.3% ± 6.7%，对照组：0.6 ± 6.5%，P=0.023，d=1.200）。APA的A/P速度（PCS：-38.8 + 33.1%，对照组：-19.8 + 43.9%，P=0.094）、APA的M/L位移（PCS：-34.8 ± 21.8%，对照组：-10.6 ± 25.3%，P=0.313）或认知任务表现（PCS：-2.7 ± 10.8%，对照组：-0.2 ± 4.3%，P=0.321）没有明显的组间差异：结论：PCS 参与者在计划和执行任务过程中的 DTC 均较高（较低），且效应大小较大（d>0.80）。PCS 参与者还采用了 "姿态-秒 "策略，将注意力资源不恰当地分配给了认知任务。这些缺陷可能会影响患者完成日常生活活动的能力，并限制他们的功能独立性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of physical medicine and rehabilitation 医学-康复医学

CiteScore

6.20

自引率

4.70%

发文量

495

审稿时长

38 days

期刊介绍： The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities. Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.