Head Stabilization Measurements as a Potential Evaluation Tool for Comparison of Persons With TBI and Vestibular Dysfunction With Healthy Controls

Sessoms, Pinata H.; Gottshall, Kim R.; Sturdy, Jordan; Viirre, Erik

doi:10.7205/milmed-d-14-00386

Cited by 13 publications

(17 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Objective assessments of postural sway in people with mild traumatic brain injury (mTBI) often reveal increased sway of the center of mass (CoM) or center of pressure (CoP) compared with healthy controls (Guskiewicz, 2011;Haran et al, 2016;King et al, 2017;Gera et al, 2018), but these results do not inform us about how individuals may stabilize the head in space. While there is some evidence that head stabilization may be impaired while walking in those with mTBI (Sessoms et al, 2015), we are unaware of studies that specifically examine the sway of the head in individuals with mTBI during standing.…”

Section: Introductionmentioning

confidence: 99%

Head stabilization during standing in people with persisting symptoms after mild traumatic brain injury

Fino

Raffegeau

Parrington

et al. 2020

Journal of Biomechanics

View full text Add to dashboard Cite

Increased postural sway is often observed in people with mild traumatic brain injury (mTBI), but our understanding of how individuals with mTBI control their head during stance is limited. The purpose of this study was to determine if people with mTBI exhibit increased sway at the head compared with healthy controls. People with persisting symptoms after mTBI (n = 59, 41 women) and control participants (n = 63, 38 women) stood quietly for one minute in four conditions: eyes open on a firm surface (EO-firm), eyes closed on a firm surface (EC-firm), eyes open on a foam pad (EO-foam), and eyes 27 closed on foam (EC-foam). Inertial sensors at the head, sternum, and lumbar region collected tri-axial accelerations. Root-mean-square (RMS) accelerations in anteroposterior (AP) and mediolateral (ML) directions. Sway ratios between the head and sternum, head and lumbar, and sternum and lumbar region, were compared between groups. Temporal coupling of anti-phase motion between the upper and lower body angular accelerations was assessed with magnitude squared coherence and cross-spectral phase angles. People with mTBI demonstrated greater sway than controls across conditions and directions. During foam-surface conditions, the control group, but not the mTBI group, reduced ML sway at their head and trunk relative to their lumbar by increasing the expression of an anti-phase hip strategy within the frontal plane. These results are consistent with suggestions of inflexible or inappropriate postural control in people with mTBI.

show abstract

Section: Introductionmentioning

confidence: 99%

Head stabilization during standing in people with persisting symptoms after mild traumatic brain injury

Fino

Raffegeau

Parrington

et al. 2020

Journal of Biomechanics

View full text Add to dashboard Cite

show abstract

“…Similar head stabilization deficits have been reported in chronic mTBI during straight walking. 44 The precise mechanism underlying this dysfunction is unknown, but impaired integration of vestibular and proprioceptive information is a potential candidate as integration of vestibular and pelvis-to-feet proprioceptive information is necessary to maintain a heading direction. 35,45 It is currently unclear how sensory integration deficitis in persons with chronic mTBI during static postural tasks 46 translate into nonstatic tasks such as gait and turning.…”

mentioning

confidence: 99%

Abnormal Turning and Its Association with Self-Reported Symptoms in Chronic Mild Traumatic Brain Injury

Fino

Parrington

Walls

et al. 2018

Journal of Neurotrauma

View full text Add to dashboard Cite

Turning is common in daily activity and requires rapid, coordinated reorientation of the head, trunk, and pelvis toward the new direction of travel. Yet, turning gait has not been well explored in populations with mild traumatic brain injury (mTBI) who may alter their turning behavior according to self-perceived symptoms or motor dysfunction. The purpose of this study was to examine turning velocities and coordination in adults with chronic mTBI (>3 months post-injury and still reporting balance complaints) during a task simulating everyday ambulation. We hypothesized that individuals with chronic mTBI would reduce their angular velocity when turning and increase the variability of head-pelvis coordination compared with controls, and that the reduction in velocity and increased variability would be associated with their self-reported symptom score. Forty-two adults (14 chronic mTBI, 28 controls) completed the Neurobehavioral Symptom Inventory before walking 12 laps around a marked course containing two 45-degree turns, four 90-degree turns, and two 135-degree turns. Inertial sensors collected angular velocities of the head and pelvis. After adjusting for covariates, participants with chronic mTBI had significantly slower lap times and peak angular velocities of the pelvis (p < 0.01) compared with the control group. The peak velocity timing (PVT) between peak velocities of the head and pelvis, and the variability of that timing was significantly greater in participants with chronic mTBI (p < 0.01). Within the chronic mTBI group, somatosensory symptoms were associated with slower angular velocities of the head and pelvis (p = 0.03) and increased PVT variability (p < 0.01). The results suggest individuals with chronic mTBI with worse somatic symptoms have impaired head stabilization during turning in situations similar to everyday life. These results encourage future research on turning gait to examine the causal relationship between symptoms and daily locomotor function in adults with chronic mTBI.

show abstract

“…In a preliminary study of head and trunk mechanics during gait, tactical-athletes with vestibular deficit resulting from concussion were found to have asynchrony and large variability of the overall head position in relation to the pelvic COM. [7] These findings warrant further investigation due to the small sample size and large observed variability. [7] Therefore, the purpose of this study was to investigate head and trunk mechanics during gait in tactical-athletes with and without vestibular deficit following concussion.…”

Section: Introductionmentioning

confidence: 92%

Head and body dyskinesia during gait in tactical athletes with vestibular deficit following concussion

Fraser¹,

VanDehy

Bodell

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

BackgroundVestibular deficit is common following concussion and may affect gait. The purpose of this study was to investigate differences in head and pelvic center of mass (COM) movement during gait in tactical athletes with and without concussion-related central vestibular impairment.Methods25 patients with post-concussion vestibular impairment (20 males, 4 females; age: 31.7±7.9 years; BMI: 27.3±3.3) and 25 matched controls (21 males, 4 females; age: 31.8±6.4 years; BMI: 27.2±2.6) participated. Three-dimensional head and pelvic COM displacement and velocities were collected at a 1.0 m/s standardized treadmill walking speed and assessed using Statistical Parametric Mapping t-tests. Maximum differences (dmax) between groups were reported for all significant kinematic findings.ResultsThe Vestibular group demonstrated significantly diminished anteroposterior head excursions (dmax=2.3 cm, p=0.02;) and slower anteroposterior (dmax=0.37 m/s, p=0.01), mediolateral (dmax=0.47 m/s, p=0.02) and vertical (dmax=0.26 m/s, p<0.001) velocities during terminal stance into pre-swing phases compared to the Control group. Vertical pelvic COM excursion was significantly increased in midstance (dmax=2.4 cm, p=0.03) and mediolaterally during pre- to initial-swing phases (dmax=7.5 cm, p<0.001) in the Vestibular group. In addition, Pelvic COM velocities of the Vestibular group were higher mediolaterally during midstance (dmax=0.19 m/s, p=0.02) and vertically during post-initial contact (dmax=0.14 m/s, p<0.001) and pre-swing (dmax=0.16 m/s, p<0.001) compared to the Control group.SignificanceThe Vestibular group demonstrated a more constrained head movement strategy during gait compared with Controls, a finding that is likely attributed to a neurological impairment of visual-vestibular-somatosensory integration.

show abstract

Head Stabilization Measurements as a Potential Evaluation Tool for Comparison of Persons With TBI and Vestibular Dysfunction With Healthy Controls

Cited by 13 publications

References 21 publications

Head stabilization during standing in people with persisting symptoms after mild traumatic brain injury

Head stabilization during standing in people with persisting symptoms after mild traumatic brain injury

Abnormal Turning and Its Association with Self-Reported Symptoms in Chronic Mild Traumatic Brain Injury

Head and body dyskinesia during gait in tactical athletes with vestibular deficit following concussion

Contact Info

Product

Resources

About