Executive dysfunction following a mild traumatic brain injury revealed in early adolescence with locomotor-cognitive dual-tasks

Abstract

Objective: To compare gait parameters between children in early adolescence (EA) with and without a mild traumatic brain injury (mTBI) during dual-task walking (DTW).

Methods: Children in EA with mTBI (n = 14; six girls) were compared to those without (n = 13; five girls) while walking in different combinations of obstacle avoidance and cognitive dual-tasks. Gait speed and fluidity and their related dual-task costs (DTC) were analysed along with foot clearance and proximity to the obstacle.

Results: No group effects were found for gait speed, proximity or clearance, but were found for fluidity DTC, specifically during the dual Stroop task and when crossing the deeper obstacle. There were also group differences for fluidity during the planning of obstacle avoidance for the narrow obstacle combined with the verbal fluency task and the deep obstacle with no cognitive task. Finally, gait fluidity showed group differences across unobstructed dual-task situations.

Conclusions: Gait fluidity may be a more sensitive variable than gait speed for revealing executive dysfunction following mTBI in EA. Assessing DTW in level walking also seems to show a potential to reveal executive dysfunctions in this age group. These results provide direction for future research on clinical assessment using DTW post-mTBI in adolescents.

Keywords:

• Executive functioning
• gait
• locomotion
• concussion
• adolescent

Acknowledgements

We thank Guy St-Vincent, PEng, MSc, for technical assistance, Jean Leblond, PhD, for statistical consulting, Isabelle Lorusso for assistance in project management and Louise Gosselin (CHU), l’Institut de réadaptation en déficience physique de Québec, CIUSSS-CN and certain physiotherapy private clinics (Cortex Medicine and Rehabilitation; PCN, Physiotherapy and Sport Medecine) for helping with recruitment.

Declaration of interest

The authors report no conflicts of interest. This project was funded by the Canadian Institutes for Health Research (CBI-127052).