Page 80 - JSOM Spring 2020

FIGURE 1 PRISMA flow diagram detailing the process by which research articles were selected.

Records identified through
database search
(n = 1632) Additional records identified
through other sources
Individual Databases: (n = 15)
• PubMed (n = 59)
• Web of Science (n = 601)
• SPORTDiscus (n = 290)
• DTIC (n = 682)

Total records identified Records excluded after title
(n = 1647) and abstract review
(n = 1547)

Records reviewed/screened Duplicate records removed
(n = 100) (n = 22)

Full-text articles excluded
Full-text articles assessed for eligibility (n = 64)
(n = 78)
Reasons:
• All subjects not tactical
athletes (n = 26)
Studies included in the review • No multitask paradigm
(n = 14) (n = 8)
• No comparison of
single-task to multitask
performance (n = 19)
• Nonresearch, review,
case study, not full-text
article (n = 11)

in the United States. 3,17,18,41–49 Eight of the studies used only κ values. The mean quality score across all studies and rat-
male participants. 3,17,18,39,42,45,46,49 ers was 13 out of a possible 33 points (range, 10–20). Seven
publications were identified with similar author groups and
Of the six studies that had males and females in their study methodology. 3,17,18,42,45,46,49
sample, none reported results based on sex. 39,41,43,44,47,48
All except one study subjected military personnel, includ- Study Findings
ing cadets, 41,43 veterans, 44,47 and those identified as “Sol-
48
diers,” 3,17,18,39,45,46 to multitask testing (Raisbeck et al. used Table 2 outlines the data extracted from each study included
law enforcement officers). Of those studies that used military in the review, with information on the participants, multitask
personnel, the Army, 17,18,42,45,46,49 Marine Corps, 3,45,46 and Air paradigm, and main findings.
Force 41,43 branches were represented. Thirteen studies used a
sample of only tactical athletes 3,17,18,39–42,44–49 and one study in- Outcome Measures
43
cluded tactical athletes and nontactical athletes in their study The motor and cognitive outcome measures for multitask
sample. Multitask assessments are commonly implemented to performance varied across the included studies. The most
determine differences between healthy and pathological indi- common measures of performance included correct/incorrect
viduals or to aid in identifying those with an injury, such as response or answer to the task demand 3,17,18,39–41,44–47 and time
mild traumatic brain injury (mTBI), for further rehabilitation to complete a task (e.g., reaction time). 3,17,18,39,40,43–47 Whole-
or treatment. Three studies included in this review evaluated body movement outcome variables, such as center of pres-
39
multitask performance of healthy individuals and those with sure, joint kinematics or kinetics, 40,42,47–49 and spatiotemporal
posttraumatic stress disorder (PTSD) or mTBI. 40,47 gait parameters, 40,47 were commonly used among the selected
44
studies to quantify motor performance. Other outcome vari-
ables used to quantify multitask performance included speed
Quality Review
of task completion, 40,41 target hits or misses, 3,17,18,43,45,46 and
Quality scores from both raters (MKT, MPB) are presented accuracy. 45–48
in Table 2. The Cohen kappa analysis revealed an average in-
terrater agreement of 0.68 or “substantial agreement.” Seven Task Paradigm
of the articles had “substantial” κ values, five articles had Six studies implemented only a dual-task paradigm, 18,39,42,44,47,48
“moderate” κ values, and two articles had “almost perfect” seven implemented only a multitask paradigm, 3,17,40,41,45,46,49 and

74 | JSOM Volume 20, Edition 1 / Spring 2020