Development of a Novel Tandem Gait Alternative Propulsion Task for Concussion Assessment in Wheelchair Sport Athletes.

CONTEXT: The Wheelchair Error Scoring System has been developed as an alternative to quantify static balance for wheelchair sport athletes. Timed tandem gait and its progressive assessments of complex and dual-task tandem gait are not able to be administered in this population due to the inability to perform heel-to-toe walking, warranting the development of a wheelchair-specific alternative. OBJECTIVE: To quantify baseline performance, modifying factor effects, and test-retest reliability of a novel tandem gait alternative propulsion task. DESIGN: Cross-sectional, repeated measures study. SETTING: University adapted athletics facility. PATIENTS OR OTHER PARTICIPANTS: Twenty-six wheelchair-using athletes (age = 21.65 ± 2.6 years, male sex, n = 14, 53.8%) from a single institution's collegiate adapted athletics program. MAIN OUTCOME MEASURES: Participants performed a baseline wheelchair propulsion task along a straight, 9-m line, completing 3 trials of single- and dual-task propulsion, by wheeling down and back as quickly as possible while staying centered along the line and constantly feeding their wheel without power pushes or gliding. Testing was repeated 1 week and 45 days later. Performance was recorded as the average time of completion for each of the 3 trials by task. Independent variables consisted of dual task, sex, and concussion history. RESULTS: Single- to dual-task differences yielded a 1.42-second slowing (P < .001) in performance. There were no differences between sexes on single- (P = .42) and dual-task (P = .38) nor concussion history on single- (P = .74) and dual-task (P = .46) conditions. Significant test-retest reliability was observed with good (intraclass correlation coefficient [ICC] = 0.79-0.82, P < .001) to moderate (ICC = 0.50-0.56, P = .001-.003) reliability at 1 week and 45 days, respectively. CONCLUSIONS: Our findings provide context for baseline performance and reliability of a novel alternative to tandem gait for wheelchair sport athletes. Whereas sex and concussion history did not modify performance, the small difference in dual-task time yields concern over the feasibility of this task as a concussion evaluation and management tool in which upper extremity neurological assessments may be warranted.