Effects of a single-task versus a dual-task paradigm on cognition and balance in healthy subjects

J Sport Rehabil. 2011 Aug;20(3):296-310. doi: 10.1123/jsr.20.3.296.


Context: Recent evidence has revealed deficiencies in the ability to divide attention after concussion.

Objective: To examine the effects of a single vs a dual task on cognition and balance in healthy subjects and to examine reliability of 2 dual-task paradigms while examining the overall feasibility of the tasks.

Design: Pretest-posttest experimental design.

Setting: Sports medicine research laboratory.

Patients: 30 healthy, recreationally active college students.

Intervention: Subjects performed balance and cognitive tasks under the single- and dual-task conditions during 2 test sessions 14 d apart.

Main outcome measures: The procedural reaction-time (PRT) test of the Automated Neuropsychological Assessment Metrics (eyes-closed tasks) and an adapted Procedural Auditory Task (PAT; eyes-open tasks) were used to assess cognition. The NeuroCom Sensory Organization Test (SOT) and the Balance Error Scoring System (BESS) were used to assess balance performance. Five 2-way, within-subject ANOVAs and a paired-samples t test were used to analyze the data. ICCs were used to assess reliability across 2 test sessions.

Results: On the SOT, performance significantly improved between test sessions (F1,29 = 35.695, P < .001) and from the single to the dual task (F1,29 = 9.604, P = .004). On the PRT, performance significantly improved between test sessions (F1,29 = 57.252, P < .001) and from the single to the dual task (F1,29 = 7.673, P = .010). No differences were seen on the BESS and the PAT. Reliability across test sessions ranged from moderate to poor for outcome measure.

Conclusions: The BESS appears to be a more reliable and functional tool in dual-task conditions as a result of its increased reliability and clinical applicability. In addition, the BESS is more readily available to clinicians than the SOT.

MeSH terms

  • Analysis of Variance
  • Attention / physiology
  • Brain Concussion / physiopathology
  • Cognition / physiology*
  • Female
  • Humans
  • Male
  • Neuropsychological Tests*
  • Postural Balance / physiology*
  • Reaction Time / physiology
  • Reproducibility of Results
  • Young Adult