Dissertation/Thesis Abstract

Dual-Task Assessment and Its Application to Lower Extremity Return to Play Testing
by Ness, Brandon Michael, Ph.D., University of South Dakota, 2019, 135; 13808690
Abstract (Summary)

Dual-task assessment in athletes has targeted those with anterior cruciate ligament (ACL) deficiency and reconstruction (ACLR) to identify motor and/or cognitive deficits. However, dual-task assessment has proven challenging in clinical environments.

Hop tests are commonly used to assist with return to play decisions after ACLR, although high rates of re-injury remain. The purpose of the three manuscript dissertation was to examine the current evidence and the feasibility of clinical dual-task assessment relevant to lower extremity performance.

A systematic review examined contemporary evidence on dual-task assessment in those with ACLR or ACL-deficient knees along with motor tasks consistent with ACL injury mechanisms. Twelve articles were included for analysis. The dual-task paradigm revealed performance deficits in those with prior ACL injury, such as prioritization of postural control at the expense of cognitive performance. Jump-landing and single-leg cutting mechanics, along with vertical jump height, suffered under dual-task conditions.

The second paper investigated the influence of visual fixation on hop test performance. Thirty-four healthy adults (age: 24.0 ± 3.9 years) completed testing through a repeated measures design utilizing the crossover triple hop (XHOP) and medial triple hop for distance (MHOP) tests under standard and visual fixation conditions. Hop distance was not altered by the addition of visual fixation (p = 0.27, d = 0.02 – 0.07); however, the addition of visual fixation slightly improved intrarater reliability, standard error of measurement, and minimal detectable change of the MHOP.

The third paper examined the simultaneous application of cognitive tasks on hop distance. Healthy participants (n = 34) completed testing through a repeated measures design, performing the XHOP and MHOP under three separate conditions: standard procedures and two dual-task protocols including working memory and visuospatial cognitive tasks. No differences in hop distance were observed with the simultaneous application of a cognitive task, with the exception of the working memory task resulting in decreased hop distance (p = 0.04, d = 0.14). There were no differences in cognitive accuracy according to task type (sitting, XHOP, MHOP). The dual-task protocol revealed good to excellent intrarater reliability for hop distance across all conditions, but lacked precision.

Indexing (document details)
Advisor: Berg-Poppe, Patti
Commitee: Kernozek, Thomas, Schweinle, Will, Zimney, Kory
School: University of South Dakota
Department: Health Sciences
School Location: United States -- South Dakota
Source: DAI-B 80/11(E), Dissertation Abstracts International
Source Type: DISSERTATION
Subjects: Physical therapy, Physiology
Keywords: Anterior cruciate ligament, Cognition, Dual-task, Hop test, Knee, Lower extremity
Publication Number: 13808690
ISBN: 978-1-392-23144-9
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