Abstract
Patients with mild traumatic brain injury complain about having balance and stability problems despite normal clinical examination. The objective of this study is to investigate the stride-to-stride gait variability of mTBI subjects while walking on treadmill under dual-task gait protocols. Fuzzy-granular computing algorithm is used to objectively quantify the stride-to-stride variability of temporal gait parameters. The degrees of similarity (DS) of temporal gait parameters in the dual tasks were determined from the corresponding granulated time-series. The mTBI group showed relatively smaller degree of similarity for all window sizes under the cognitive (dual) task walking, showing pronounced stride-to-stride variability. Different levels of DS among the mTBI subjects were observed. Individually, both healthy and mTBI group showed different DS under the two dual-tasks, reflecting the challenging level of the cognitive tasks while walking. The mean values of the temporal parameters for the mTBI group were different from the averaged normal reference. On the other hand, the individual variance analysis shows no significant differences between the normal and dual task values for some mTBI subjects. The granular approach however is able to reveal very fine differences and exhibited similar trends for all mTBI subjects. Different DS values among mTBI group could be indicative for the different severity level or the undergone rehabilitation process.
Highlights
Mild traumatic brain injury is one of the most common neurological disorders [12]
The objective of this study is to investigate the stride-to-stride gait variability of Mild traumatic brain injury (mTBI) subjects while walking on treadmill under dual-task gait protocols
The individual variance analysis shows no significant differences between the normal and dual task values for some mTBI subjects
Summary
Mild traumatic brain injury (mTBI) is one of the most common neurological disorders [12]. The CDC acknowledged mTBI as a serious public health problem in the United States in its 2003 report [9] to the US congress. This report pointed out, mTBI is underestimated by the current “surveillance methods” and some people with mTBI show no sign of abnormalities under the clinical diagnosis techniques and made recommendation for further research and studies [9]. Research findings in two studies [10,11] indicated that mTBI could be misdiagnosed and altered cognitive and behavioral functions may still exist even years after mTBI. Many people with mTBI suffer from balance and stability problems even though the clinical neuropsychological examinations show no sign of abnormality [10]. Gaetz et al reported the insensitivity of the standard clinical EEG technique to most brain functions change after mTBI [22]
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