Balance performance with a cognitive task: A dual-task testing paradigm

Purpose: Athletic performance demands simultaneous use of cognitive and postural control capabilities. Decrements to both systems have been observed following concussion. This study evaluated a dual-task methodology to establish the tenability of using this testing model in concussed athletes. Methods: Nonconcussed subjects were assessed over 2 d. Subjects were introduced to the task-switching cognitive assessment test and a NeuroCom Smart Balance Master postural control assessment protocol on day 1. In the following session, subjects were evaluated on postural control and cognitive function tests independently (single task), and then concurrently (dual task). Results: Significant improvements were seen in three of the four balance conditions and in three of the four reaction times when the cognitive and balance task were performed simultaneously (P < 0.05). No significant balance by cognitive task interaction was revealed (P > 0.05): however. significant differences existed in reaction time based on stimulus position and increasing balance demands (P < 0.05). Conclusion: Combining the cognitive and balance assessments resulted in healthy subjects showing improved performance when compared with individual task performance. The dual-task methodology brought about systematic changes to reaction time in relation to increasing balance demands. The ability of this protocol to detect changes in postural control or cognitive function following concussive injury requires further study.