Table 2.

Summary of search 2 terms: studies investigating dual-task gait after concussion

Study	Cohort	Na (M/F)	Testing time	Testing conditions	Outcome measures	Interpretation
Parker et al. [73]	Collegiate athletes	20 (8/12)	Within 48 h post-concussion	Single- and dual-task gait (Q&A); tested using motion capture	Gait velocity, stride length, stride time, step width COM ROM and VEL; COM-COP distance	Decreased dynamic stability in dual-task following concussion: greater ML sway
Parker et al. [31]	Collegiate athletes	30 (18/12)	2, 5, 14, and 28 d post-concussion	Single- and dual-task gait (Q&A); tested using motion capture	Gait velocity, stride length, step width COM ROM and VEL, COM-COP distance	More conservative dual-task gait (slower and greater COM-COP distance) 28 d post-concussion compared with controls
Catena et al. [74]	College students	28 (16/12)	Within 48 h post-concussion	Single- and dual-task gait (Q&A); tested using motion capture	Gait velocity, stride length, step width COM ROM and VEL, COM-COP distance	Greater COM motion and velocity during single- and dual-task gait following concussion
Catena et al. [77]	College students	28 (16/12)	Not stated	Single- and dual-task gait (Q&A), obstacle cross; tested using motion capture	Gait velocity, stride length, step width COM ROM and VEL, COM-COP distance	Adaptation of conservative gait post-concussion, more in Q&A condition than obstacle cross or single-task gait
Parker et al. [79]	Collegiate athletes and non-athletes	56 (N/A)	2, 5, 14, and 28 d post-concussion	Single- and dual-task gait (Q&A); tested using motion capture	Gait velocity, COM ROM and VEL, COM-COP distance	Dual-task balance control impairments up to 1 mo following concussion. Athletes walked slower than non-athletes during single/dual-task gait
Catena et al. [76]	College students	60 (32/28)	2, 5, 14, and 28 d post-concussion	Single- and dual-task gait (Q&A), obstacle cross; tested using motion capture	COM ROM, COM VEL, COM-COP distance	Within 48 h of concussion, conservative single-task gait was observed. By 28 d post-injury, COM motion control during obstacle crossing was observed
Catena et al. [72]	College students	20 (10/10)	2, 6, 14, and 28 d post-concussion	Single- and dual-task gait (Stroop); tested using motion capture	COM ROM, COM VEL, Stroop reaction time	Individuals with concussion walked with slower sagittal plane COM motion and displayed attentional capacity deficits compared with controls
Martini et al. [70]	College students with and without a concussion history	68 (37/31)	Average of 6.3 y post-concussion for those with a concussion history	Single- and dual-task gait (Brooks-Spatial Memory Task); tested using GaitRITE	Gait velocity, step length, stride width, stance time	Those with a history of concussion walked slower than those without during single-task gait only
Chiu et al. [78]	Collegiate athletes	46 (28/18)	Within 48 h of concussion	Single- and dual-task gait (Q&A), obstacle cross; tested using motion capture	Obstacle clearance distance, cognitive task accuracy, inter-joint coordination (continuous relative phase)	Participants with concussion walked slower during Q&A and obstacle crossing compared with controls. These conditions also induced greater joint coordination pattern changes for those with a concussion
Fait et al. [52]	Elite athletes	12 (8/4)	Average of 37 d post-concussion	Single- and dual-task gait (visual Stroop); tested using motion capture	Symptoms, neurocognitive function, maximum gait speed, minimal COM obstacle clearance, response errors, cognitive dual-task costs	No differences between healthy and concussion groups for symptoms or neurocognitive function. Those with a concussion had greater minimal COM obstacle clearance and greater dual-task costs than controls
Howell et al. [29]	Adolescent athletes	40 (36/4)	2, 8, 17, 30, and 59 d post-concussion	Single- and dual-task gait (auditory Stroop); tested using motion capture	Symptoms, mean gait velocity, step length, step width, COM ROM, COM VEL, dual-task costs	Symptom resolution occurred for all but 4 concussion subjects by 59 d post-injury. Dual-task COM ROM and VEL and dual-task costs were higher in concussion subjects at 59 d post-injury compared with controls
Howell et al. [50]	Adolescent athletes	46 (40/6)	2, 8, 17, 30, and 59 d post-concussion	Single- and dual-task gait (single/continuous auditory Stroop, and Q&A); tested using motion capture	Symptoms, COM ROM, COM VEL, average gait velocity	Symptoms resolved on average within 2 wk of concussion. As task complexity increased, gait stability decreased for the concussion group
Cossette et al. [98]	Young adult athletes	21 (9/12)	Average of 158 d post-concussion	Single- and, dual-task gait (Stroop, verbal fluency, arithmetic), and obstacle crossing; tested using motion capture	Average gait velocity, dual-task costs	The concussion group exhibited greater dual-task costs, particularly during obstacle avoidance
Howell et al. [30]	Adolescent athletes	38 (32/6)	Before and after return-to-activity clearance	Single- and dual-task gait (auditory Stroop); tested using motion capture	Change across time in COM ROM, COM VEL, average gait velocity, symptoms, attention	During dual-task conditions, frontal plane gait worsened after return to activity for concussion patients. No changes in single-task gait, symptoms, or attention for controls
Howell et al. [80]	Adolescent and young adult athletes	76 (52/24)	2, 8, 17, 30, and 59 d post-concussion	Dual-task gait (auditory Stroop); tested using motion capture	COM ROM, COM VEL, symptoms	Symptoms resolved by 2 wk and 1 mo post-concussion for young adults and adolescents, respectively. Gait balance control deficits were greater for adolescents post-concussion than young adults
Howell et al. [75]	Adolescent and young adult athletes	17 (10/7)	2, 8, 17, 30, and 59 d post-concussion	Dual-task gait (auditory Stroop); tested using an accelerometer	Average gait velocity, peak anterior acceleration, peak medial/lateral acceleration	During dual-task walking, participants with concussion displayed less peak medial–lateral acceleration than control participants during 55–75% of the gait cycle
Howell et al. [13]	Adolescent and young adult athletes	29 (21/8)	Average of 58 d post-concussion	Single- and dual-task gait (auditory Stroop); tested using motion capture	Time to return to activity, COM ROM, COM VEL, symptoms	A strong correlation exists between time required to return to physical activity and dual-task COM motion at 2 mo post-concussion
Sambasivan et al. [53]	Physically active children and adolescents	48 (28/20)	Average of 43 d post-concussion	Single- and dual-task gait (counting backwards by 3 s); tested using GaitRITE, BESS test	Stride width, step length, double support time, BESS errors	Children with concussion show single-task and obstacle cross gait deficits, even after self-reported symptom resolution. No dual-task deficits found
Fino [51]	Collegiate athletes	9 (6/3)	Average: 7, 16, 23, 29, 37, 45, and 363 d post-injury	Single- and dual-task gait (Q&A); tested using body-worn accelerometers	Gait speed, stride time variability, Lyapunov exponents (local dynamic stability)	The addition of a cognitive dual task influenced stability in the concussed group more than in the control group, despite similar ST stability
Fino et al. [97]	Collegiate athletes	8 (2/6)	Average: 7, 16, 23, 29, 37, and 45 d post-injury	Single- and dual-task gait (serial subtraction by 7 s); tested using motion capture	Kinematic turning characteristics	Altered turning kinematics were detected during gait despite absence of clinical deficits
Howell et al. [81]	Child and adolescent athletes	68 (28/40)	Average of 9 d post-injury	Single- and dual-task gait (Q&A); tested using body-worn accelerometers	Average gait speed, cadence, double support time, gait cycle duration, stride length	Those with a history of multiple concussions prior to a subsequent concussion displayed smaller DT stride lengths than controls, no difference during ST walking
Martini et al. [71]	General community	77 (44/33)	Average of 5.8–48.5 y post-injury	Single- and dual-task gait (Brooks-Spatial Memory Task), obstacle cross, obstacle cross with dual task; tested using motion capture	Gait velocity, step width, stride length, double support time, toe clearance over obstacle	There were no observable gait differences between those with and without a history of concussion occurring during adolescence

All studies compared post-concussion participants with uninjured control participants, unless otherwise noted

BESS Balance Error Scoring System, COM whole-body center of mass, COP center of pressure, DT dual-task, F female, M male, ML medial-lateral, N/A not available, Q&A question and answer test (spelling words backwards, reciting the months in reverse order, or serial subtraction), ROM range of motion, ST single-task, VEL velocity

^aN indicates the total sample size (concussion and control groups), broken into total F and M participants