Changes in postural sway and performance of functional tasks during rehabilitation after traumatic brain injury

Wade, Lauren; Canning, Colleen G.; Fowler, Virginia; Felmingham, Kim L.; Baguley, Ian

doi:10.1016/s0003-9993(97)90136-2

Cited by 58 publications

(51 citation statements)

References 8 publications

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“…Broad based gait and the prolonged time of double limb support indicate postural instability of the children with brain injuries. Accordingly, increased body sway has been measured in adult patients with TBI (Geurts et al 1996, Wade et al 1997. In contrast to a previous study of adult patients with brain injury (Ochi et al 1999), we found no significant difference between left and right step lengths, probably because the symptoms were less lateralized in our patient sample.…”

Section: Discussioncontrasting

confidence: 99%

Sensorimotor recovery in children after traumatic brain injury: analyses of gait, gross motor, and fine motor skills

Kuhtz-Buschbeck

Hoppe

Gölge

et al. 2003

Develop Med Child Neuro

101

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The recovery of gait, gross motor proficiency, and hand function was examined in 23 children (13 males, 10 females; age 4 years 7 months to 15 years 10 months) with traumatic brain injury (TBI) over five months of in patient rehabilitation. We used gait analysis, the Gross Motor Function Measure, the Developmental Hand Function Test, and the Purdue Pegboard test. Brain injury had been severe (initial Glasgow Coma Scale GCS <8) in 17 children and moderate (GCS 8–10) in six children. Compared with healthy control children of the same age and sex, repeated gait analyses in ambulatory children with brain injury showed significant reductions of velocity, stride length and cadence, and impaired balance. Spatiotemporal gait variables were correlated with Gross Motor Function Measure scores. Hand function tests revealed deficits in fine motor skills, speed, and coordination. Degree of impairment increased with trauma severity. Despite significant improvements, differences in gait velocity, stride length, and hand function of children with brain injuries and controls were still present about 8 months after TBI. Hand motor skills improved less than gait. Young age at injury was not associated with better recovery.

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Section: Discussioncontrasting

confidence: 99%

Sensorimotor recovery in children after traumatic brain injury: analyses of gait, gross motor, and fine motor skills

Kuhtz-Buschbeck

Hoppe

Gölge

et al. 2003

Develop Med Child Neuro

101

View full text Add to dashboard Cite

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“…Duong and colleagues subsequently replicated this finding in a larger sample [5]. Several investigators have reported that early balance impairment predicts worse outcome at rehabilitation discharge [27][28][29]. Early residual motor impairment may also be associated with poorer vocational outcome after severe TBI.…”

Section: Discussionmentioning

confidence: 91%

Motor impairment after severe traumatic brain injury: A longitudinal multicenter study

Walker

Pickett²

2007

JRRD

198

141

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Abstract-Neuromotor impairment is a common sequela of severe traumatic brain injury (TBI) but has been understudied relative to neurocognitive outcomes. This multicenter cohort study describes the longitudinal course of neurological examination-based motor abnormalities after severe TBI. Subjects were enrolled from the four lead Department of Veterans Affairs and Defense and Veterans Brain Injury Center sites. The study cohort consisted of 102 consecutive patients (active duty, veteran, or military dependent) with severe TBI who consented during acute rehabilitation for data collection and completed all follow-up evaluations. Paresis, ataxia, and postural instability measures showed a pattern of improvement over time, with the greatest improvement occurring between the inpatient (baseline) and 6-month follow-up assessments. Involuntary movement disorders were rare at all time points. Two years following acute rehabilitation, more than one-third of subjects continued to display a neuromotor abnormality on basic neurological examination. Persistence of tandem gait abnormality was particularly common.

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“…[10] Gait abnormalities that result from decreased balance, including reduced step size and velocity, have also been noted to slow the rehabilitative process. [17] Deficient balance has also been shown to be a strong indicator of increased length of stay, [10] and predictor of motor and overall functional ability at discharge from rehabilitation. [7] Despite the efforts of inpatient rehabilitation professionals, balance deficits continue to persist long term in this population, and have a marked negative impact.…”

Section: Effect Of Balance Deficitsmentioning

confidence: 99%

“…Diminished balance ability has been shown to be associated with longer inpatient rehabilitation length of stay, [7,10] increased risk of falling, [16] slowed recovery, increased medical complications [10] and gait abnormalities. [17] Despite improvements in balance that have been found to occur from 0 to 6 months post injury (the time during which inpatient rehabilitation most often takes place), [8] balance impairments have been shown to persist long past inpatient rehabilitation, and are one of the most commonly noted chronic deficits in this population, with distinct impairments noted in research examining patients with TBI at one, two, five and more than 20 years post injury. [8,18,19] These long term deficits have been associated with decreased mobility and functional abilities after inpatient rehabilitation discharge, and have been shown to hinder community participation, including decreased ability to ambulate in the community, navigate surfaces with minor obstacles, safely cross streets, enter or drive automobiles, board public transportation and participate in leisure activities.…”

mentioning

confidence: 99%

Virtual reality-based therapy for the treatment of balance deficits in patients receiving inpatient rehabilitation for traumatic brain injury

et al. 2014

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Thesis directed by Assistant Clinical Professor Cynthia Harrison-Felix.Balance deficits are one of the most commonly occurring and physically limiting sequlae that result from more severe traumatic brain injury (TBI). The purpose of this study was to evaluate the effectiveness and applicability of using a commercially available virtual reality (VR) system as a treatment of these deficits for patients receiving inpatient rehabilitation for a primary diagnosis of TBI by conducting analyses of data collected as part of a pilot randomized controlled trial. The aims of this thesis were: (1) to examine the relationships between treatment received (VR or Extra Standard of Care) and static and dynamic balance changes over time; (2) to assess the predictive validity of the VR game scores on static and dynamic balance; and (3) to investigate dose response relationships between study treatments and changes in static and dynamic balance.Results indicate that patients receiving either treatment demonstrated significant balance improvements over time; however, neither treatment condition was found to be significantly better than the other. Scores from the VR balance games were found to have some moderately strong associations with the standardized assessment of static balance, with less strong relationships between VR scores and standardized assessments of dynamic balance. The results did not suggest the existence of any relationship between the amount of treatment received and changes in standardized assessments of balance. These data provide an essential first step in the establishment of the use of iv commercially available VR systems as effective tools for treating balance deficits for patients with TBI.The form and content of this abstract are approved. I recommend its publication.

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Changes in postural sway and performance of functional tasks during rehabilitation after traumatic brain injury

Cited by 58 publications

References 8 publications

Sensorimotor recovery in children after traumatic brain injury: analyses of gait, gross motor, and fine motor skills

Sensorimotor recovery in children after traumatic brain injury: analyses of gait, gross motor, and fine motor skills

Motor impairment after severe traumatic brain injury: A longitudinal multicenter study

Virtual reality-based therapy for the treatment of balance deficits in patients receiving inpatient rehabilitation for traumatic brain injury

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