Using a dual-task protocol to investigate motor and cognitive performance in healthy children and youth

Mild traumatic brain injury (or concussion) is a prevalent yet understudied health concern in children and youth. This injury can cause dysfunction in both motor and cognitive domains; however, most literature focuses on single-task neuropsychological tests which only assess cognition. Although dual-task research on concussed children and youth is needed as many daily activities require both motor and cognitive domains, we must first investigate whether performing simultaneous motor and cognitive tasks of varied complexity impact these domains in healthy children and youth.

Data collected from 106 healthy children and youth (5-18 years) created a normative dataset. Participants performed motor (postural stability) and cognitive (visual attention) tasks under single- and dual-task conditions. The cognitive task difficulty remained constant while the motor task had four conditions of increasing difficulty. The relationship between the number of correct responses (cognitive performance) and sway index (motor performance) was determined using two repeated measures ANOVAs (p<0.05).

Dual-task conditions resulted in reduced postural stability, with greater differences on the foam surface (F_2,206=16.070, p<0.0005). No statistically significant differences were observed in attention (F_4,101=0.713, p=0.584).

Postural stability decreased under dual-task conditions, but attention was maintained or improved. Consequently, attention took precedence over postural control when performing tasks concurrently, demonstrating the ability for dual-task methodology to isolate specific processes. This study provides a normative dataset to be used during clinical management to identify functional deficits following concussion and acts as a starting point to explore dual-task protocols in children and youth following concussion.