Tandem gait test performance in healthy, physically active adults: Clinical implications for concussion evaluation

Area of Science:

• Neurology
• Sports Medicine
• Biomechanics

Background:

• The tandem gait test is used to assess neurological function and balance.
• Understanding factors influencing tandem gait performance is crucial for accurate clinical interpretation.

Purpose of the Study:

• To identify factors affecting performance on the tandem gait test in healthy, physically active adults.
• To evaluate the validity of current tandem gait test recommendations.

Main Methods:

• A cross-sectional study design was employed.
• Participants (n=64) performed the tandem gait test following Sport Concussion Assessment Tool 3 (SCAT3) guidelines.
• Performance metrics included time (best trial, segments) and pass/fail status, analyzed against sex, concussion history, foot length, height, and trial count.

Main Results:

• A high rate (55%) of healthy adults failed the initial trial, and 19% had a best time under 14 seconds.
• Sex and concussion history did not significantly impact performance (p>0.05).
• Foot length and height showed low to negligible correlations with test scores, while turning segments exhibited greater variability (COV=27%) than straight segments (COV=18%).

Conclusions:

• Current tandem gait test protocols may lead to a high false-positive rate in healthy, active individuals.
• Factors like sex, concussion history, trial count, and anthropometrics have minimal influence on test outcomes.
• Clinicians should consider the high variability in turning times and potential for false positives when interpreting tandem gait test results.