2012 Annual Conference

Mcgaugh, Janna

UTMB, Galveston, Texas

Concussion is an injury that poses widely publicized challenges in athletics. Time to recovery and the long term consequences of concussion injuries in student athletes is relatively undetermined at this time. Texas passed a concussion law in 2011 which mandates baseline cognitive testing in all student athletes. However, recent literature advocates that baseline testing should include a postural control measure and symptom history questionnaire in addition to cognitive assessment. Moreover, emerging evidence suggests that student athletes have significant deficiencies in the ability to divide attention or perform a dual task after concussion.  Physical performance testing that includes dual tasking may provide a more sensitive measure of injury recovery.  The purpose of this study was to gather data on postural control measures with and without dual tasking in a random sample of intermediate and high school student athletes.

Twenty-six student athletes aged 11 to 18 years with a mean of 14.07±1.93 years were recruited at a pre participation examination (PPE) screening

Subjects received a written questionnaire upon enrollment which provided demographic information such as age, height, weight, primary sport and position and then asked questions regarding concussion history and concussion symptoms following a hit to the head. Subjects then performed two postural control measures, the Balance Error Scoring System (BESS) and the computerized modified Clinical Test of Sensory Interaction of Balance (m-CTSIB). Two trials were performed, (1) the standard single task BESS and m-CTSIB followed by (2) a dual task condition on the BESS and m-CTSIB in which subjects were provided an adapted Procedural Auditory Task to perform during the measure.

Paired t-tests were used (SPSS Version 18) to compare performance means between the two testing conditions (standard versus dual task).

Twenty six subjects completed questionnaires and performed the postural control assessment testing. The results of the m-CTSIB demonstrated that there is a relative increase in sway with each progression of the testing conditions in both standard and dual task testing conditions. (standard: condition 1: 0.84+/-5.3; condition 2: 1.07+/-0.43; condition 3: 1.29+/-0.72; condition 4: 2.96+/-0.94) (dual task: condition 1: 0.96+/-0.56; condition 2: 1.23+/-0.56; condition 3: 1.20+/-0.37; condition 4: 2.81+/-0.78).  There was no statistical difference between standard and dual task testing conditions for any of the testing conditions (p > 0.05.) The BESS showed similar results between the two testing conditions, with 17.11+/-8.86 errors with the standard assessment and 17.38+/-9.57 errors with dual tasking (p=0.73).

Sway increased expectedly throughout conditions in both single task and dual task testing. The sample included student athletes with and without history of concussion or symptoms who were all asymptomatic on testing date, suggesting that both measures may yield similar results at baseline screenings.

A single or dual task postural control measure appears to be able to capture baseline measurement in student athletes prior to their season for a particular sporting activity.