Title:

Multi-tasking in Adults with Traumatic Brain Injury: Examining the Impact of Concurrent Motor and Cognitive tasks

Author: Frasca, Diana
Issue Date: Nov-2015
Abstract (summary): After moderate-severe traumatic brain injury (TBI), community reintegration is a well-documented challenge. A focus of this dissertation is the role of balance in community integration: Balance impairments, shown to correlate with poorer community integration, are a common and enduring consequence of TBI; moreover, even in patients who appear to be well-recovered in balance control, residual impairment can be revealed when examined with multi-tasking paradigms. Multi-tasking is a particularly important capacity for community integration because so many activities that enable people to successfully engage in the community require concurrent performance of motor and cognitive tasks. To date, limited research has examined static postural control and cognitive performance after moderate-severe TBI, and no studies have examined postural control in the context of facial emotion perception (FEP). However, this combination is particularly relevant to community integration because many inter-personal activities (e.g., having coffee with a friend, speaking with an employer) require both. Therefore the overall aims of this dissertation were to examine the relationship between multi-tasking and community integration, and better characterize multi-tasking impairment after TBI, employing postural control measures designed to simulate real-world functioning plus a conventionally used cognitive test (the Stroop), and a newly developed measure of FEP designed to provide a more ecologically valid assessment of this capacity in TBI. We first demonstrated that balance correlated with early, but not later community integration, and balance functioning that necessitated multi-tasking in the earlier stages of recovery correlated with community integration in the later stages. We developed an FEP task using an indirect test format to permit implicit processing that employed dynamic faces and provided environmental context; we demonstrated preliminarily that it was feasible for brain-injured adults. Finally, in comparing adults with TBI to controls, we found that when combining postural control and Stroop tasks, only postural control was affected in TBI. These findings extended to the indirect FEP task. Taken together, the findings suggest that early identification of multi-tasking impairment and targeted intervention might improve long-term community integration. Further research is required to better understand the mechanisms that underlie multi-tasking impairment after TBI in order to design such targeted interventions.
Content Type: Thesis

Permanent link

https://hdl.handle.net/1807/70830

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