Reliability and Minimal Detectable Change for a Smartphone-Based Motor-Cognitive Assessment: Implications for Concussion Management

Our purpose was to investigate the reliability and minimal detectable change characteristics of a smartphone-based assessment of single- and dual-task gait and cognitive performance. Uninjured adolescent athletes (n = 17; mean age = 16.6, SD = 1.3 y; 47% female) completed assessments initially and again 4 weeks later. The authors collected data via an automated smartphone-based application while participants completed a series of tasks under (1) single-task cognitive, (2) single-task gait, and (3) dual-task cognitive-gait conditions. The cognitive task was a series of continuous auditory Stroop cues. Average gait speed was consistent between testing sessions in single-task (0.98, SD = 0.21 vs 0.96, SD = 0.19 m/s; P = .60; r = .89) and dual-task (0.92, SD = 0.22 vs 0.89, SD = 0.22 m/s; P =.37; r =.88) conditions. Response accuracy was moderately consistent between assessments in singletask standing (82.3% accurate, SD = 17.9% vs 84.6% accurate, SD = 20.1%; P =.64; r = .52) and dual-task gait (89.4% accurate, SD = 15.9% vs 85.8% accurate, SD = 20.2%; P =.23; r = .81) conditions. Our results indicate automated motor-cognitive dualtask outcomes obtained within a smartphone-based assessment are consistent across a 1-month period. Further research is required to understand how this assessment performs in the setting of sport-related concussion. Given the relative reliability of values obtained, a smartphone-based evaluation may be considered for use to evaluate changes across time among adolescents, postconcussion.

Automated summary

The results of this study suggest that the automated motor-cognitive dual-task outcomes obtained within a smartphone-based assessment remain consistent over a one-month period. Both gait speed and response accuracy were relatively stable between testing sessions, indicating the potential for smartphone-based evaluations to be used for assessing changes over time among adolescents, particularly those recovering from concussions.