Dual-tasking in closed head injury patients: a comparison between paper-and-pencil and computerized tasks

Closed Head Injuries (CHI) is a rapidly growing public health problem and a significant cause of comorbidity and mortality. The causes behind CHI are heterogeneous. Traffic accidents constitute 50% of the epidemiology, accidental falls and domestic accidents represent 25%, and sports activities are involved in 10% of the cases. Finally, the male-to-female prevalence is about 2:1 (Zanier, 2021). Likely due to their inhomogeneity, closed-head injury patients are little studied. Nonetheless, CHIs represent the primary cause of chronic disability around the world (Dang et al., 2017). As a worldwide important public health problem, we believe targeting these patients is necessary. In the present study, we tested 17 patients (age mean=42, min=22, max=66) who were dismissed from the San Bortolo Hospital in Vicenza after a closed-head injury (CHI). We selected patients who obtained a performance similar to healthy controls in the cognitive paper-and-pencil tasks at the time of discharge. Regarding independence after recovery, we excluded patients who ended up in a nursing home or needed assistance daily. We focused on contacting patients who went back to having an active role in society, returning to their previous homes, and working. The average time between their CHI and our testing was 28 months (min=7, max=50). Moreover, the average time spent in the hospital was heterogeneous, with a mean of 40 days (min=7, max=122). Our aim was to investigate whether the ability to multitask was still deficient, regardless of recovered attentional and memory skills. In order to do so, we presented them with some experimental dual-tasking computerized tests, together with some paper-and-pencil tests routinely used by clinicians to test memory, attention, and executive functions. We furthermore asked them to fill in some questionnaires on how the CHI event had influenced their life, whether they perceived having cognitive difficulties, and how it affected their quality of life. This whole procedure aimed at having a 360-degree view of the possible difficulties people who have had CHI might encounter. The thesis is divided into four chapters. In the first chapter, we give a theoretical overview of the tested cognitive functions and how they are affected by CHIs. The second chapter describes how the study was performed. We will here discuss aims, participants, and procedure. In the third chapter, the results are listed. Finally, in the fourth and final chapter, the results of the research will be discussed, highlighting the limitations, future prospects, and possible clinical implications.