Date Presented 04/22/2023

OT has a role in assessing sports-related concussion symptoms in children to prevent inappropriate return to play and further injuries that extend the length of recovery. Dual-task assessments have increased sensitivity to detect these deficits.

Primary Author and Speaker: Ghazala T. Saleem

Additional Authors and Speakers: Jillian Lawton, Gianna Yurchak, Adam T. Sing, Anna Kromer

Contributing Authors: Anna Kromer, Jillian Lawton, Adam T. Sing, Pak Hin Tang, Gianna Yurchak, Ghazala T. Saleem

PURPOSE: The purpose of this study was to determine the effects of dual-task activities on postural control and stability in children diagnosed with a sport-related concussion.

DESIGN: The study utilized a cross-sectional design. The participants were recruited using a convenience sampling method by putting flyers up around the community and contacting local schools. The study recruited 16 participants who were divided into two groups for data collection: a control group and a concussion group.

METHOD: The participants in the control (N=10) and concussion group (N=6) ranged from 8-17 years old. All participants completed subjective assessments including; GAD-7, PHQ-9, ABC Scale, and PCSS, in addition to the objective assessments including; MoCA, Computerized Posturography Assessment, BESS. Independent t-tests were used to analyze data. The primary outcome variable is the difference in the number of errors from single to dual-task activities, which represents either the motor-motor or motor-cognitive change score.

RESULTS: This study revealed statistically significant differences between the concussion group and control group for the motor-motor change score (p = .046). The results from the MoCA were significantly different between the two groups (p = .001). The results from the PANESS were significantly different as well (p = .011).

DISCUSSION: Dual-motor activities reveal more underlying postural control deficits compared to that of single-task activities for the concussion group. Therefore, dual-motor activities should be used as the primary assessment to detect impairments rather than single-task activities due to the increased sensitivity. Occupational therapists have a pivotal role in understanding and assessing these deficits in order to promote better outcomes in patients’ health and well-being. Further research on dual tasking activities is required to identify underlying postural impairments within children with concussion.


Fabri, T. L., Wilson, K. E., Holland, N., Hickling, A., Murphy, J., Fait, P., & Reed, N. (2017). Using a Dual-task Protocol to Investigate Motor and Cognitive Performance in Healthy Children and Youth. Gait & posture, 54, 154–159.

Howell, B. (2017). The Association between Dual-Task Gait after Concussion and Prolonged Symptom Duration. Journal of Neurotrauma, 34(23), 3288–3294.

Howell, D. R., Mayer, A. R., Master, C. L., Leddy, J., Zemek, R., Meier, T. B., … Meehan, W. P. (2020). Prognosis for Persistent Post Concussion Symptoms using a Multifaceted Objective Gait and Balance Assessment Approach. Gait & Posture, 79, 53–59.

Hung, Y., Meredith, G., & Gill, S. (2013). Influence of Dual-task Constraints During Walking for Children. Gait & Posture, 38(3), 450–454.