Dosage of Dual Task in Sport Related Concussion: A developing science

The year of innovation, part II of III. Consider the concept of dual task (DT) dosage. How do we increase, categorize and stratify dual task testing and delivery? Most importantly, how do we ensure that recovering patients have been exposed to and rehabilitated-through – before returning to sport, work, school and life. The science of DT does not currently cover this consideration of categorization and dosage. I will present the full details on this in two upcoming continuing education classes, one at re+Active PT during the Neuropracticity 4.0 class; and in the June 19th evening concussion course for Providence Medical Center. This sneak peek is merely an introduction. DT can have an increased dosage through: novelty, pressure, or volume. As an example of these, I will preview pressure in context of of sport related concussion (SRC). Consider loading recovering athletes with pressure-filled contexts (as their symptoms allow). Providing novel distractions is more challenging (loading). Similarly, delivering treatment with pressure, is of a higher load. Finally, volume is the third realm. Volume, in sport related concussion, can come in these:

Amount of sensory processing (lights, sound)

Duration (play, half, game, between rotations)

Amount of information

Working memory (holding tank) amount/data

Multi-task physical (manual or otherwise)

Physical load (weight vest)

Length of field, court to cover

Increased responsibilities (opponents to cover)

It is a necessary part of rehabilitation, that we introduce novelty, pressure and volume, so that athletes do not experience these for the first time, in the context of a meaningful game. Again, this is only a peek, and not a full primer even on the concepts of these three parameters of dosage.