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Robertson D, Lempke LB, Lynall RC. Analyzing Dual-Task Paradigms to Improve Postconcussion Assessment and Management. J Sport Rehabil 2024; 33:356-364. [PMID: 38897580 DOI: 10.1123/jsr.2023-0292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 04/06/2024] [Accepted: 04/12/2024] [Indexed: 06/21/2024]
Abstract
CONTEXT Dual-task (simultaneous cognitive-motor activities) assessments have been adapted into reliable and valid clinical concussion measures. However, abundant motor and cognitive variations leave researchers and clinicians uncertain about which combinations elicit the intended dual-task effect. Our objective was to examine differences between commonly employed dual-task motor and cognitive combinations among healthy, college-aged individuals. DESIGN Cross-sectional laboratory study. METHODS Twenty participants (age: 21.3 [2.4] y; height: 176.0 [9.1] cm; mass: 76.0 [16.4] kg; 20% with concussion history) completed 4 motor tasks (gait, tandem gait, single-leg balance, and tandem balance) under 5 cognitive conditions (single task, subtraction, month reversal, spelling backward, and visual Stroop) in a research laboratory. The motor performance outcomes were spatiotemporal variables for gait and tandem gait and center of pressure path length (in centimeters) for single-leg and tandem balance. Cognitive outcomes were response rate (responses/second) and cognitive accuracy. We used separate repeated-measures analyses of variance for each motor and cognitive outcome with post hoc Tukey t tests. RESULTS Gait velocity, gait stride length, and tandem gait velocity demonstrated significant cognitive-motor interactions (P's < .001) such that all dual-task conditions resulted in varyingly slower or shorter movement than single task. Conversely, single-leg balance (P = .627) and tandem balance (P = .434) center of pressure path length did not significantly differ among the dual-task cognitive conditions or relative to single task. Statistically significant cognitive-motor interactions were observed only for spelling backward accuracy (P = .004) and response rates for spelling backward, month reversal, and visual Stroop (P's < .001) such that worse accuracy, but faster response rates, occurred during motor tasks. CONCLUSIONS Gait and tandem gait motor tasks accompanied with spelling backward or subtraction cognitive tasks demonstrated consistently strong dual-task effects and, therefore, may be the best suited for clinical and research use following concussion.
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Affiliation(s)
- Diana Robertson
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens, GA, USA
- UGA Biomechanics Laboratory, Department of Kinesiology, University of Georgia, Athens, GA, USA
| | - Landon B Lempke
- Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA
| | - Robert C Lynall
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens, GA, USA
- UGA Biomechanics Laboratory, Department of Kinesiology, University of Georgia, Athens, GA, USA
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Nedergaard JSK, Christensen MS, Wallentin M. Mind over body: Interfering with the inner voice is detrimental to endurance performance. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 68:102472. [PMID: 37665911 DOI: 10.1016/j.psychsport.2023.102472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/01/2023] [Accepted: 06/04/2023] [Indexed: 09/06/2023]
Abstract
In two preregistered experiments, we investigated whether covert language is involved in sustained physical efforts, specifically if people are less able to push themselves physically when distracted from using inner speech. In both experiments, participants performed 12 cycling trials (Experiment 1: N = 49; Experiment 2: N = 50), each lasting 1 min where participants were required to cycle as fast as possible while simultaneously engaging in either a visuospatial task, a verbal task or no interference. Experiment 1: Participants performed worse in the verbal interference condition compared with the control condition (d = 0.29) and verbal interference performance was numerically but not significantly worse than visuospatial interference (d = 0.22). Experiment 2: A more demanding interference task yielded significant slower cycling with verbal interference compared to both control (d = 1) and visuospatial interference (d = 0.43). These results indicate that inner speech plays a causal role in control of sustained physical efforts.
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Affiliation(s)
- Johanne S K Nedergaard
- Department of Linguistics, Cognitive Science, and Semiotics, Aarhus University, Denmark.
| | - Mark Schram Christensen
- Department of Psychology, Cognition, Intention and Action Group, University of Copenhagen, Denmark; Department of Neuroscience, Christensen Lab, University of Copenhagen, Denmark
| | - Mikkel Wallentin
- Department of Linguistics, Cognitive Science, and Semiotics, Aarhus University, Denmark
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Chen SF, Wang Y, Peng Y, Zhang M. Effects of Attrition Shoes on Balance Control Ability and Postural Stability Following a Single-Leg Drop Jump Landing. Healthcare (Basel) 2023; 11:1127. [PMID: 37107961 PMCID: PMC10137797 DOI: 10.3390/healthcare11081127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/10/2023] [Accepted: 03/10/2023] [Indexed: 04/29/2023] Open
Abstract
The purpose of the study is to determine the influence of lateral-heel-worn shoes (LHWS) on balance control ability through the single-leg drop jump test. The results could be beneficial by preventing lower limb injuries. Eighteen healthy participants performed the single-leg drop jump test. Times to stabilization for ground reaction forces (TTSG) in the anterior/posterior, medial/lateral, and vertical directions were calculated to quantify dynamic balance control ability. Outcome variables of the center of pressure (COP) were used to examine the main effect of LHWS during the static phase. The postural control ability was assessed through time to stabilization for the center of mass (TTSC) in the three directions. TTSG and TTSC for the LHWS group were found to be longer than those for the new shoes (NS) group in the M/L direction (p < 0.05). An increase in the TTS revealed an increased risk of falls during physical activities. However, no significant effects for both TTSG and TTSC were found in the other two directions between LHWS and NS groups. A static phase was cropped using TTSG for each trial, which indicated a phase after participants obtained balance. Outcome measures derived from COP showed no significant effects in the static phase. In conclusion, LHWS weakened balance control ability and postural stability in the M/L direction when compared to the NS group. During the static phase, no significant differences were found between the LHWS group and the NS group in balance control ability and postural stability. Consequently, lateral-worn shoes might increase the risk of fall injuries. The results could serve as an evaluation of shoe degradation for individuals with the aim of avoiding the risk of falls.
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Affiliation(s)
- Shane-Fei Chen
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Yan Wang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China
- Research Institute for Sports Science and Technology, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Yinghu Peng
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China
- Research Institute for Sports Science and Technology, The Hong Kong Polytechnic University, Hong Kong 999077, China
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Verbal interference paradigms: A systematic review investigating the role of language in cognition. Psychon Bull Rev 2022; 30:464-488. [PMID: 35996045 DOI: 10.3758/s13423-022-02144-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2022] [Indexed: 11/08/2022]
Abstract
This paper presents a systematic review of the empirical literature that uses dual-task interference methods for investigating the on-line involvement of language in various cognitive tasks. In these studies, participants perform some primary task X putatively recruiting linguistic resources while also engaging in a secondary, concurrent task. If performance on the primary task decreases under interference, there is evidence for language involvement in the primary task. We assessed studies (N = 101) reporting at least one experiment with verbal interference and at least one control task (either primary or secondary). We excluded papers with an explicitly clinical, neurological, or developmental focus. The primary tasks identified include categorization, memory, mental arithmetic, motor control, reasoning (verbal and visuospatial), task switching, theory of mind, visual change, and visuospatial integration and wayfinding. Overall, the present review found that covert language is likely to play a facilitative role in memory and categorization when items to be remembered or categorized have readily available labels, when inner speech can act as a form of behavioral self-cuing (inhibitory control, task set reminders, verbal strategy), and when inner speech is plausibly useful as "workspace," for example, for mental arithmetic. There is less evidence for the role of covert language in cross-modal integration, reasoning relying on a high degree of visual detail or items low on nameability, and theory of mind. We discuss potential pitfalls and suggestions for streamlining and improving the methodology.
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Porter K, Quintana C, Morelli N, Heebner N, Winters J, Han DY, Hoch M. Neurocognitive function influences dynamic postural stability strategies in healthy collegiate athletes. J Sci Med Sport 2021; 25:64-69. [PMID: 34446366 DOI: 10.1016/j.jsams.2021.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 07/14/2021] [Accepted: 07/29/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Poorer neurocognitive performance may increase lower extremity injury risk due to alterations in biomechanics. However, it is unclear if poorer neurocognitive function may be associated with altered dynamic postural stability. Therefore, the purpose of this study was to investigate the relationship between neurocognitive performance and dynamic postural stability in healthy collegiate athletes. DESIGN Cross-sectional cohort. METHODS Forty-five Division-I collegiate athletes (21 males, 24 females; age: 19.69 ± 1.50) completed neurocognitive assessments from the NIH Toolbox® (NIHTB). Three groups were established from the NIHTB composite score: high performers (HP), moderate performers (MP), and low performers (LP). Additionally, participants completed a dynamic hop-to-stabilization task. Accelerometer and gyroscopic data were recorded during landing through an inertial measurement unit (IMU) on the participant's low back. The root mean squared (RMS) of the accelerometer and gyroscope was calculated for the orthogonal planes and the resultant vector. Group differences for demographic variables, NIHTB composite scores, and IMU based measures were analyzed with one-way ANOVAs with Bonferroni post hoc analyses were performed. Cohen's d effect sizes were also calculated. RESULTS Post hoc tests determined the LP group had higher vertical acceleration RMS values (p = 0.013, d = -0.85) and lower anteroposterior acceleration RMS values (p = 0.005, d = 0.95) compared to the HP group. CONCLUSIONS Neurocognitive performance may influence dynamic postural stability strategies in athletes. Higher neurocognitive performers may use different approaches to perform difficult postural tasks by adopting strategies associated with lower vertical and higher anteroposterior acceleration compared to lower neurocognitive performers.
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Affiliation(s)
- Ke''La Porter
- Sports Medicine Research Institute, College of Heath Sciences, Department of Athletic Training and Clinical Nutrition, University of Kentucky, United States of America
| | - Carolina Quintana
- Athletic Training Program, Department of Kinesiology, California State University, Fresno, United States of America
| | - Nathan Morelli
- Sports Medicine Research Institute, College of Heath Sciences, Department of Athletic Training and Clinical Nutrition, University of Kentucky, United States of America
| | - Nicholas Heebner
- Sports Medicine Research Institute, University of Kentucky, United States of America
| | - Joshua Winters
- Sports Medicine Research Institute, University of Kentucky, United States of America
| | - Dong Y Han
- Department of Neurology, College of Medicine, University of Kentucky, Lexington, Kentucky, United States of America
| | - Matthew Hoch
- Sports Medicine Research Institute, College of Heath Sciences, Department of Athletic Training and Clinical Nutrition, University of Kentucky, United States of America.
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Single- Versus Dual-Task Functional Movement Paradigms: A Biomechanical Analysis. J Sport Rehabil 2021; 30:774-785. [PMID: 33494045 DOI: 10.1123/jsr.2020-0310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/25/2020] [Accepted: 11/03/2020] [Indexed: 11/18/2022]
Abstract
CONTEXT Laboratory-based movement assessments are commonly performed without cognitive stimuli (ie, single-task) despite the simultaneous cognitive processing and movement (ie, dual task) demands required during sport. Cognitive loading may critically alter human movement and be an important consideration for truly assessing functional movement and understanding injury risk in the laboratory, but limited investigations exist. OBJECTIVE To comprehensively examine and compare kinematics and kinetics between single- and dual-task functional movement among healthy participants while controlling for sex. DESIGN Cross-sectional study. SETTING Laboratory. Patients (or Other Participants): Forty-one healthy, physically active participants (49% female; 22.5 ± 2.1 y; 172.5 ± 11.9 cm; 71.0 ± 13.7 kg) enrolled in and completed the study. INTERVENTION(S) All participants completed the functional movement protocol under single- and dual-task (subtracting by 6s or 7s) conditions in a randomized order. Participants jumped forward from a 30-cm tall box and performed (1) maximum vertical jump landings and (2) dominant and (3) nondominant leg, single-leg 45° cuts after landing. MAIN OUTCOME MEASURES The authors used mixed-model analysis of variances (α = .05) to compare peak hip, knee, and ankle joint angles (degrees) and moments (N·m/BW) in the sagittal and frontal planes, and peak vertical ground reaction force (N/BW) and vertical impulse (Ns/BW) between cognitive conditions and sex. RESULTS Dual-task resulted in greater peak vertical ground reaction force compared with single-task during jump landing (mean difference = 0.06 N/BW; 95% confidence interval [CI], 0.01 to 0.12; P = .025) but less force during dominant leg cutting (mean difference = -0.08 N/BW; 95% CI, -0.14 to -0.02; P = .015). Less hip-flexion torque occurred during dual task than single task (mean difference = -0.09 N/BW; 95% CI, -0.17 to -0.02). No other outcomes were different between single and dual task (P ≥ .053). CONCLUSIONS Slight, but potentially important, kinematic and kinetic differences were observed between single- and dual-task that may have implications for functional movement assessments and injury risk research. More research examining how various cognitive and movement tasks interact to alter functional movement among pathological populations is warranted before clinical implementation.
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Phillips D, dos Santos FV, Santoso M. Sudden visual perturbations induce postural responses in a virtual reality environment. THEORETICAL ISSUES IN ERGONOMICS SCIENCE 2021. [DOI: 10.1080/1463922x.2020.1870052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- David Phillips
- Department of Exercise Science and Physical Education, Montclair State University, Montclair, NJ, USA
| | | | - Markus Santoso
- Digital Worlds Institute, University of Florida, Gainesville, FL, USA
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Traditional Neuropsychological Testing Does Not Predict Motor-Cognitive Test Performance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207393. [PMID: 33050599 PMCID: PMC7600978 DOI: 10.3390/ijerph17207393] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/05/2020] [Accepted: 10/07/2020] [Indexed: 11/16/2022]
Abstract
The ecological validity of neuropsychological testing (NT) has been questioned in the sports environment. A frequent criticism is that NT, mostly consisting of pen and paper or digital assessments, lacks relevant bodily movement. This study aimed to identify the determinants of a newly developed testing battery integrating both cognitive and motor demands. Twenty active individuals (25 ± 3 years, 11 males) completed the new motor-cognitive testing battery (MC), traditional NT (Stroop test, Trail Making test, Digit Span test) and isolated assessments of motor function (MF; Y-balance test, 20m-sprint, counter-movement jump). Kendal’s tau and partial Spearman correlations were used to detect associations between MC and NT/MF. Except for two items (Reactive Agility A and counter-movement jump; Run-Decide and sprint time; r = 0.37, p < 0.05), MC was not related to MF. Similarly, MC and NT were mostly unrelated, even when controlling for the two significant motor covariates (p > 0.05). The only MC item with (weak to moderate) associations to NT was the Memory Span test (Digit Span backwards and composite; r = 0.43–0.54, p < 0.05). In sum, motor-cognitive function appears to be largely independent from its two assumed components NT and MF and may represent a new parameter in performance diagnostics.
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Lynall RC, Campbell KR, Mauntel TC, Blackburn JT, Mihalik JP. Single-Legged Hop and Single-Legged Squat Balance Performance in Recreational Athletes With a History of Concussion. J Athl Train 2020; 55:488-493. [PMID: 32216655 DOI: 10.4085/1062-6050-185-19] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Researchers have suggested that balance deficiencies may linger during functional activities after concussion recovery. OBJECTIVE To determine whether participants with a history of concussion demonstrated dynamic balance deficits as compared with control participants during single-legged hops and single-legged squats. DESIGN Cross-sectional study. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 15 previously concussed participants (6 men, 9 women; age = 19.7 ± 0.9 years, height = 169.2 ± 9.4 cm, mass = 66.0 ± 12.8 kg, median time since concussion = 126 days [range = 28-432 days]) were matched with 15 control participants (6 men, 9 women; age = 19.7 ± 1.6 years, height = 172.3 ± 10.8 cm, mass = 71.0 ± 10.4 kg). INTERVENTION(S) During single-legged hops, participants jumped off a 30-cm box placed at 50% of their height behind a force plate, landed on a single limb, and attempted to achieve a stable position as quickly as possible. Participants performed single-legged squats while standing on a force plate. MAIN OUTCOME MEASURE(S) Time to stabilization (TTS; time for the normalized ground reaction force to stabilize after landing) was calculated during the single-legged hop, and center-of-pressure path and speed were calculated during single-legged squats. Groups were compared using analysis of covariance, controlling for average days since concussion. RESULTS The concussion group demonstrated a longer TTS than the control group during the single-legged hop on the nondominant leg (mean difference = 0.35 seconds [95% confidence interval = 0.04, 0.64]; F2,27 = 5.69, P = .02). No TTS differences were observed for the dominant leg (F2,27 = 0.64, P = .43). No group differences were present for the single-legged squat on either leg (P ≥ .11). CONCLUSIONS Dynamic balance-control deficits after concussion may contribute to an increased musculoskeletal injury risk. Given our findings, we suggest that neuromuscular deficits currently not assessed after concussion may linger. Time to stabilization is a clinically applicable measure that has been used to distinguish patients with various pathologic conditions, such as chronic ankle instability and anterior cruciate ligament reconstruction, from healthy control participants. Whereas the single-legged squat may not sufficiently challenge balance control, future study of the more dynamic single-legged hop is needed to determine its potential diagnostic and prognostic value after concussion.
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Affiliation(s)
- Robert C Lynall
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens
| | - Kody R Campbell
- Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill
| | - Timothy C Mauntel
- US Department of Defense-Veterans Affairs Extremity Trauma and Amputation Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD.,Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - J Troy Blackburn
- Human Movement Science Curriculum, Division of Allied Health Sciences, Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill
| | - Jason P Mihalik
- Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill
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Postural Stability Under Dual-Task Conditions: Development of a Post-Concussion Assessment for Lower-Extremity Injury Risk. J Sport Rehabil 2020; 29:131-133. [DOI: 10.1123/jsr.2018-0358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 01/24/2019] [Accepted: 03/10/2019] [Indexed: 11/18/2022]
Abstract
Context: Concussions are consequence of sports participation. Recent reports indicate there is an increased risk of lower-extremity musculoskeletal injury when returning to sport after concussion suggesting that achieving “normal” balance may not fully indicate the athlete is ready for competition. The increased risk of injury may indicate the need to refine a screening tool for clearance.
Objective: Assess the between-session reliability and the effects of adding a cognitive task to static and dynamic postural stability testing in a healthy population.
Setting: Clinical laboratory.
Participants: Twelve healthy subjects (6 women; age 22.3 [2.9] y, height 174.4 [7.5] cm, weight 70.1 [12.7] kg) participated in this study.
Design: Subjects underwent static and dynamic postural stability testing with and without the addition of a cognitive task (Stroop test). Test battery was repeated 10 days later. Dynamic postural stability testing consisted of a forward jump over a hurdle with a 1-legged landing. A stability index was calculated. Static postural stability was also assessed with and without the cognitive task during single-leg balance. Variability of each ground reaction force component was averaged.
Main Outcome Measures: Interclass correlation coefficients (ICC2,1) were computed to determine the reliability. Standard error of measure, mean standard error, mean detectable change, and 95% confidence interval were all calculated.
Results: Mean differences between sessions were low, with the majority of variables having moderate to excellent reliability (static .583–.877, dynamic .581–.939). The addition of the dual task did not have any significant effect on reliability of the task; however, generally, the ICC values improved (eyes open .583–.770, dual task .741–.808).
Conclusions: The addition of a cognitive load to postural stability assessments had moderate to excellent reliability in a healthy population. These results provide initial evidence on the feasibility of dual-task postural stability testing when examining risk of lower-extremity musculoskeletal injury following return to sport in a concussed population.
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The effect of mental tracking task on spatiotemporal gait parameters in healthy younger and middle- and older aged participants during dual tasking. Exp Brain Res 2019; 237:3123-3132. [DOI: 10.1007/s00221-019-05659-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 09/21/2019] [Indexed: 11/26/2022]
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Effect of Single-Leg Squat Speed and Depth on Dynamic Postural Control Under Single-Task and Dual-Task Paradigms. J Appl Biomech 2019; 35:272-279. [PMID: 31034324 DOI: 10.1123/jab.2018-0327] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Although single-leg squats are a common dynamic balance clinical assessment, little is known about the relationship between parameters that influence squat movement and postural control performance. The objective of this study was to determine the relationships between squat parameters (speed and depth) and postural control under single task and dual task. A total of 30 healthy college students performed single-leg squats under single task and dual task with Stroop. Random-intercepts generalized linear mixed models determined the effect of squat parameters on center of pressure (CoP) parameters. For each 1-cm·s-1 increase in squat speed, sway range (mediolateral: β = -0.03; anteroposterior: β = -0.05) and area (β = -0.25) decreased, whereas sway speed (mediolateral: β = 0.05; anteroposterior: β = 0.29; total: β = 0.29) increased. For each 1-cm increase in squat depth, sway range (mediolateral: β = 0.05; anteroposterior: β = 0.20) and area (β = 0.72) increased, whereas sway speed (anteroposterior: β = -0.14; total: β = -0.14) decreased. Compared with single task, the association between total and anteroposterior sway speed and squat speed was stronger under dual task. Clinicians and researchers should consider monitoring squat speed and depth when assessing dynamic balance during single-leg squats, as these parameters influence postural control, especially under dual task.
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Verdini F, Zara C, Leo T, Mengarelli A, Cardarelli S, Innocenti B. Assessment of patient functional performance in different knee arthroplasty designs during unconstrained squat. Muscles Ligaments Tendons J 2018; 7:514-523. [PMID: 29387646 DOI: 10.11138/mltj/2017.7.3.514] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background In this paper, squat named by Authors unconstrained because performed without constrains related to feet position, speed, knee maximum angle to be reached, was tested as motor task revealing differences in functional performance after knee arthroplasty. It involves large joints ranges of motion, does not compromise joint safety and requires accurate control strategies to maintain balance. Methods Motion capture techniques were used to study squat on a healthy control group (CTR) and on three groups, each characterised by a specific knee arthroplasty design: a Total Knee Arthroplasty (TKA), a Mobile Bearing and a Fixed Bearing Unicompartmental Knee Arthroplasty (respectively MBUA and FBUA). Squat was analysed during descent, maintenance and ascent phase and described by speed, angular kinematics of lower and upper body, the Center of Pressure (CoP) trajectory and muscle activation timing of quadriceps and biceps femoris. Results Compared to CTR, for TKA and MBUA knee maximum flexion was lower, vertical speed during descent and ascent reduced and the duration of whole movement was longer. CoP mean distance was higher for all arthroplasty groups during descent as higher was, CoP mean velocity for MBUA and TKA during ascent and descent. Conclusions Unconstrained squat is able to reveal differences in the functional performance among control and arthroplasty groups and between different arthroplasty designs. Considering the similarity index calculated for the variables showing statistically significance, FBUA performance appears to be closest to that of the CTR group. Level of evidence III a.
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Affiliation(s)
- Federica Verdini
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Claudio Zara
- Casa di Cura Stella Maris, San Benedetto del Tronto, Italy
| | - Tommaso Leo
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Alessandro Mengarelli
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Stefano Cardarelli
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Bernardo Innocenti
- BEAMS Department, École polytechnique de Bruxelles, ULB - Université Libre de Bruxelles, Bruxelles, Belgium
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Lynall RC, Mauntel TC, Pohlig RT, Kerr ZY, Dompier TP, Hall EE, Buckley TA. Lower Extremity Musculoskeletal Injury Risk After Concussion Recovery in High School Athletes. J Athl Train 2017; 52:1028-1034. [PMID: 29140128 DOI: 10.4085/1062-6050-52.11.22] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Although an association between concussion and musculoskeletal injury has been described in collegiate and professional athletes, no researchers have investigated an association in younger athletes. OBJECTIVE To determine if concussion in high school athletes increased the risk for lower extremity musculoskeletal injury after return to activity. DESIGN Observational cohort study. SETTING One hundred ninety-six high schools across 26 states. PATIENTS OR OTHER PARTICIPANTS We used data from the National Athletic Treatment, Injury and Outcomes Network surveillance system. Athletic trainers provided information about sport-related concussions and musculoskeletal injuries in athletes in 27 sports, along with missed activity time due to these injuries. MAIN OUTCOME MEASURE(S) Three general estimating equations were modeled to predict the odds of sustaining (1) any lower extremity injury, (2) a time-loss lower extremity injury, or (3) a non-time-loss lower extremity injury after concussion. Predictors were the total number of previous injuries, number of previous concussions, number of previous lower extremity injuries, number of previous upper extremity injuries, and sport contact classification. RESULTS The initial dataset contained data from 18 216 athletes (females = 39%, n = 6887) and 46 217 injuries. Lower extremity injuries accounted for most injuries (56.3%), and concussions for 4.3% of total injuries. For every previous concussion, the odds of sustaining a subsequent time-loss lower extremity injury increased 34% (odds ratio [OR] = 1.34; 95% confidence interval [CI] = 1.13, 1.60). The number of previous concussions had no effect on the odds of sustaining any subsequent lower extremity injury (OR = 0.97; 95% CI = 0.89, 1.05) or a non-time-loss injury (OR = 1.01; 95% CI = 0.92, 1.10). CONCLUSIONS Among high school athletes, concussion increased the odds of sustaining subsequent time-loss lower extremity injuries but not non-time-loss injuries. By definition, time-loss injuries may be considered more severe than non-time-loss injuries. The exact mechanism underlying the increased risk of lower extremity injury after concussion remains elusive and should be further explored in future research.
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Affiliation(s)
- Robert C Lynall
- Department of Kinesiology, The University of Georgia, Athens
| | - Timothy C Mauntel
- Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, MD
| | - Ryan T Pohlig
- Biostatistics Core Facility, University of Delaware, Newark
| | - Zachary Y Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Thomas P Dompier
- Datalys Center for Sports Injury Research and Prevention, Inc, Indianapolis, IN
| | - Eric E Hall
- Department of Exercise Science, Elon University, NC
| | - Thomas A Buckley
- Department of Kinesiology and Applied Physiology and Interdisciplinary Program in Biomechanics and Movement Science, University of Delaware, Newark
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