Dual-Task Tandem Gait and Average Walking Speed in Healthy Collegiate Athletes

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Abstract

Objectives:

To (1) examine the association between a commonly used concussion test, tandem gait, in single/dual-task conditions with single-task and dual-task average walking speed, (2) characterize the prevalence of tandem gait false positives, and (3) develop a normative reference range of dual-task tandem gait times.

Design:

Cross-sectional study.

Setting:

Two NCAA collegiate athletic facilities.

Independent Variables:

Athletes completed the tandem gait test and a gait evaluation in single/dual-task conditions during a preseason examination.

Main Outcome Measures:

Associations between tandem gait times and average walking speeds were evaluated using multiple linear regression models. Various tandem gait test time pass/fail cutoffs were calculated to examine false-positive rates.

Results:

Among the 171 participants (103 men, 19.8 ± 1.2 years of age), dual-task tandem gait completion times were independently associated with dual-task average walking speed [β = −4.018; 95% confidence interval (CI), −7.153 to −0.883], but single-task associations were not found. Male gender was associated with faster tandem gait times in both single-task (β = −0.880, 95% CI, −1.731 to −0.029) and dual-task conditions (β = −2.225, 95% CI, −3.691 to −0.759). A pass/fail cutoff threshold of 14 seconds resulted in a 2% false-positive rate for single-task tandem gait, while it resulted in a 29% false-positive rate during dual-task tandem gait.

Conclusions:

Average walking speed and dual-task tandem gait represent objective measures that are useful in concussion management. While a single-task tandem gait cutoff of 14 seconds seems appropriate for males, adjustments may be necessary based on sex and alternate pass/fail criteria may be appropriate for dual-task tandem gait.

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