The influence of cognitive dual tasks on concussion balance test performance

Objective: To determine the influence of a cognitive dual task on postural sway and balance errors during the Concussion Balance Test (COBALT). Methods: Twenty healthy adults (12 females, eight males; aged 21.95 ± 3.77 years; height = 169.95 ± 9.95 cm; weight = 69.58 ± 15.03 kg) partook in this study and completed single- and dual-task versions of a reduced COBALT. Results: Sway velocity decreased during dual-task head rotations on foam condition (p = .021, ES = −0.57). A greater number of movement errors occurred during dual-task head rotations on firm surface (p = .005, ES = 0.71), visual field flow on firm surface (p = .008, ES = 0.68), and head rotations on foam surface (p < .001, ES = 1.61) compared with single-task conditions. Cognitive performance was preserved throughout different sensory conditions of the COBALT (p = .985). Discussion: Cognitive dual tasks influenced postural control and destabilized movements during conditions requiring advanced sensory integration and reweighting demands. Dual-task versions of the COBALT should be explored as a clinical tool to identify residual deficits past the acute stages of concussion recovery.