Dual-Task Posture Performance in Older Adults with Mild Traumatic Brain Injury

Abstract

Introduction: Fall-related mild traumatic brain injuries (mTBIs) are a prevalent problem among the older population. mTBIs lead to the development of postural control impairments which may persist and lead to further injury. Testing dual-task posture performance may be an appropriate screening and monitoring tool of postural performance for mTBI, but further evidence is needed. Objective: To compare single and dual-task posture performance in older adults with mTBI. Methods: This was a cross-sectional study with a recruitment of n=4. Demographic data was collected first. Participants, who were all at least 65 years of age or older, were then tested for dual-task posture performance using an AMTI force platform. Participants were instructed to complete two repetitions of single and dual tasks involving posture in a randomly chosen sequence. The motor task was standing with their feet apart on the force platform. The cognitive task entailed counting backwards from a 3-digit number by an interval of 3 in their head. Each task on the platform lasted for 60 seconds. Outcome measures included 95% confidence area (mm2), center of pressure (COP) path length (mm), COP velocity (mm/s), and mean frequency (Hz). A repeated measures analysis of variance on single and dual task posture parameters was conducted to determine the influence of dual tasking on posture. Results: Out of the 4 participants, there were 2 females. The average time since diagnosis was 430.75 days ± 295.72 days and the average Montreal Cognitive Assessment score was 21.33/30 points. There was no significant Condition by Measure interaction (F(1,3)=0.22, p=0.67, ?p 2=0.07). There was no significant main effect of Condition (F(1,3)=0.22, p=0.67, ?p 2=0.07). Conclusion: No significant difference was found between single and dual-task parameters, which included 95% confidence area (mm2), center of pressure (COP) path length (mm), COP velocity (mm/s), and mean frequency (Hz). This was surprising as it was expected that dual tasking would provoke impairments in postural control parameters. However, data collection is ongoing so these findings should be interpreted with caution. Refined screening and monitoring protocols for fall-related mTBIs may the improve time to diagnosis, prevent reinjury, and mitigate long term impairments.