An assessment of gait and balance deficits after traumatic brain injury

Abstract

Basford JR, Chou L-S, Kaufman KR, Brey RH, Walker A, Malec JF, Moessner AM, Brown AW. An assessment of gait and balance deficits after traumatic brain injury. Arch Phys Med Rehabil 2003;84:343-9. Objective: To assess the sensations of instability that many patients report after traumatic brain injury (TBI). Design: A controlled study. Setting: A motion analysis and vestibular and balance laboratory. Participants: Twenty subjects, 10 with TBI and complaints of instability, and 10 without TBI. Interventions: Balance and gait analysis. Main Outcome Measures: Dizziness Handicap Inventory (DHI), caloric irrigation, optokinetic testing, Dix-Hallpike Test, posturography, and center of mass (COM) movement. Results: Subjects were well matched in terms of age, height, weight, and gender. DHI scores of those with and without TBI differed significantly (32.2[plusmn]23.0 vs 0.2[plusmn]0.63, P[lt ].001). Caloric and optokinetic circularvection testing were abnormal only in subjects with TBI (8/10 and 4/10, respectively). Benign paroxysmal positioning vertigo was present in only 3 subjects with TBI, and this either resolved spontaneously (n=1) or was successfully treated (n=2). Composite posturography scores of those with and without TBI differed significantly (69.6[plusmn]35.8 vs 79.5[plusmn]40.5, P=.02). Gait parameters also differed significantly between the groups ( P=.05), with the subjects with TBI having lower anterior and posterior and higher medial and lateral COM displacements and velocities. Conclusions: Patients' complaints of instability after TBI may have objective correlates and may be rectifiable. Balance and gait testing in these patients is warranted. [copy ] 2003 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation