Utility of a Postural Stability/Perceptual Inhibition Dual Task for Identifying Concussion in Adolescents

Abstract

Context: Research in the area of dual-task paradigms to assess sport-related concussion (SRC) status is growing, but additional assessment of this paradigm in adolescents is warranted. Design: This case-control study compared 49 adolescent athletes aged 12–20 years with diagnosed SRC to 49 age- and sex-matched controls on visual–spatial discrimination and perceptual inhibition (PIT) reaction time tasks performed while balancing on floor/foam pad conditions. Methods: The SRC group completed measures at a single time point between 1 and 10 days postinjury. Primary outcomes were dual-task reaction time, accuracy, and sway. General linear models evaluated differences between groups (P < .05). Logistic regression identified predictors of concussion from outcomes. Area under the curve evaluated discriminative ability of identifying SRC. Results: Results supported significantly higher anterior–posterior (AP) sway values in concussed participants for visual–spatial discrimination and PIT when balancing on the floor (P = .03) and foam pad (P = .03), as well as mediolateral sway values on the floor during visual–spatial discrimination (P = .01). Logistic regression analysis (R2 = .15; P = .001) of all dual-task outcomes identified AP postural sway during the PIT foam dual task as the only significant predictor of concussed status (ß = −2.4; P = .004). Total symptoms (area under the curve = 0.87; P