Running and Thinking: Unmasking the Lingering Effects of Sports Concussions Through Complex Dual-Task Testing

Objective: This study investigated gait and cognitive dual-task costs under a dual-task paradigm that was more challenging than the traditional tasks used in research. Methods: A total of 43 18–25-year-old male and female student athletes were recruited (20 asymptomatic concussed athletes who suffered at least one concussion 2.79–7.92 months before testing, 23 never concussed). Athletes performed a complex rapid decision-making and executive function computerized task while walking continuously and maintaining a predetermined speed on a non-motorized treadmill (6.5 km/h). The outcome measures were gait and cognitive dual-task costs. Results: Repeated-measures ANOVAs were conducted to evaluate group differences. Pearson correlations were conducted to evaluate the association between dual-task costs and concussion injury variables. The results showed that both groups experienced greater difficulty with dual-task performance related to gait, whereas only the concussion group exhibited poorer cognitive performance under the dual-task condition (both not significant). The significant correlation between time since injury and gait dual-task cost (r = −0.72, p < 0.001) indicated that athletes with a more recent concussion increased their gait speed whilst athletes with an older concussion reduced their gait speed during the dual-task. Moreover, the cognitive dual-task cost was significantly correlated to symptom recovery (r = 0.461, p = 0.047), suggesting that a longer recovery time from concussion is associated with an increased dual-task cost. Conclusions: While dual-task gait alterations were common to both groups, only individuals with a history of concussion showed specific cognitive impairments under dual-task conditions. The observed associations between dual-task costs and both time since injury and symptom recovery underscore the potential of complex dual-task assessments to provide nuanced insights into post-concussion recovery trajectories and to detect subtle, lingering deficits.