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Effect of concurrent cognitive tasks on gait features among children post-severe traumatic brain injury and typically-developed controls

Aim: To investigate and compare the influence of concurrent cognitive tasks on gait characteristics in children post-traumatic brain injury (TBI) and typically-developed (TD) controls. Methods: Fifteen children post-TBI (aged 9.5 ± 2.2 years) and 15 TD controls (aged 9.9 ± 1.3 years) were included in the study. The children were asked to walk under three conditions: (1) walking at a self-selected speed, (2) walking at a self-selected speed while memorizing and recalling a series of three random numbers and (3) walking at a self-selected speed while listening and identifying commonly experienced sounds. Gait parameters include walking speed, step time and length and step time and length variability as measured with the GAITRite® system. Results: Introduction of a concurrent task led to decreased walking speed and step length and increased step time and step length variability in both groups, but with a significantly prominent effect in children post-TBI. The results also showed that the effect of a concurrent cognitive task on walking depended on the complexity level of the task. Conclusion: When children were asked to perform an additional task while they were walking, this had a negative effect on their gait. One may deduce from these results that control of the rhythmic stepping mechanism at a self-selected walking speed in children is dependant to an extent on their ability to focus attention on their gait. In children post-TBI who usually have an attention deficit anyway, this ability is severely disturbed.