Talking while Walking After Concussion: Acute effects of concussion on speech pauses and gait speed

Background: Deficits in dual-tasks (DT) are frequently observed post-concussion (i.e., mild Traumatic Brain Injury). However, traditional DT may not be relevant to daily life. Walking while talking elicits DT costs in healthy adults and is part of daily life. Objective: We investigated the effect of concussion on walking with extemporaneous speech and explored relationships between DT and acute symptoms. Methods: Participants with recent concussion (<14 days post-injury) and controls completed three tasks: single-task gait without speaking (STG), single-task speaking without walking (STS) and walking while speaking (DT). Silent pauses in speech audio reflected cognitive performance, and gait was quantified using inertial sensors. We used linear mixed models to compare groups and conditions and explored associations with self-reported symptoms. Results: Both concussion (n=19) and control (n=18) groups exhibited longer speech pauses (p < 0.001), slower walking speeds (p < 0.001), and slower cadence (p < 0.001) during the DT compared to ST conditions. There were no group differences or interactions for speech pauses (p > 0.424). The concussion group walked slower (p = 0.010) and slowed down more during DT than the control group (group*task p = 0.032). Vestibular symptoms strongly associated with ST speech pause duration (ρ = 0.72), ST gait speed (ρ = -0.75), and DT gait speed (ρ = -0.78). Conclusions: Extemporaneous speech is well-practiced, but challenging to complete while walking post-concussion. Strong associations between DT outcomes and vestibular-related symptoms suggest DT deficits vary with post-concussion symptomology. DT deficits may be deleterious to daily tasks post-concussion.