Article

OBJECTIVE: To identify different combinations of physical (level, obstacle
avoidance, stepping down) and cognitive (visual, mental) demands within a
locomotor navigational context that best discriminates between persons with mild
traumatic brain injury (MTBI) and control subjects for an eventual clinical tool
to assess residual executive dysfunction. DESIGN: Group comparison study.
SETTING: Rehabilitation facility. PARTICIPANTS: Volunteer sample (N=14) of
persons with MTBI (n=7) (6 women; age, 20+/-1.6 y) and a comparison group (n=7)
of subjects without neurologic problems (6 women; age, 22.4+/-1.4 y).
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Gait speed (m/s) and
dual-task cost calculated as the relative change in gait speed from single (no
cognitive task) to dual tasks for the same gait condition. RESULTS: There were
significant interactions between groups and cognitive tasks and between groups
and cognitive and physical tasks for gait speed. Specifically, the MTBI group
walked slower than control subjects in the dual-task conditions when stepping
over an obstacle combined with each cognitive task. When gait speed was measured
as dual-task costs, group differences were more evident, except for stepping
down. CONCLUSIONS: These preliminary results suggest that both absolute gait
speed and calculated dual-task costs during the combination of stepping over an
obstacle with a simultaneous cognitive task are sensitive to revealing executive
dysfunction in persons with MTBI. Gait speed can be easily measured in the clinic
to provide important information to make diagnoses and decide about return to
play or function. Continued work building on these preliminary results is needed
toward the development of a clinical tool.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS