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(R) 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.