The use of the dual-task paradigm in detecting gait performance deficits following a sports-related concussion: a systematic review and meta-analysis.

OBJECTIVES: The purpose of this systematic review was to determine the viability of the dual-task paradigm in the evaluation of a sports-related concussion. DESIGN: Systematic review and meta-analysis. METHODS: Eight electronic databases were searched from their inception until the 11(th) of April 2011. Studies were grouped according to their reported gait performance variables and their time(s) of assessment(s). Raw mean differences (MD) and 95% confidence intervals (CI) were calculated based on raw means and standard deviations for gait performance measures in both single- and dual-task conditions. Dual-task deficits were pooled using a random effects model and heterogeneity (I(2)) between studies was assessed. RESULTS: Ten studies representing a total sample of 168 concussed and 167 matched (age and gender) non-concussed participants met the inclusion criteria. Meta-analysis demonstrated that dual-task performance deficits were detected (p<0.05) in the concussed group for gait velocity (GV) (MD=-0.133; 95% CI -0.197, -0.069) and range of motion of the centre of mass in the coronal plane (ML-ROM) (MD=0.007; 95% CI 0.002, 0.011), but not in the non-concussed group; GV (MD=-0.048; 95% CI -0.101, 0.006), ML-ROM (MD=0.002; 95% CI -0.001, 0.005). CONCLUSIONS: The results of this study indicate that GV and ML-ROM are sensitive measures of dual-task related changes in concussed patients and should be considered as part of a comprehensive assessment for a sports-related concussion.