Dynamic balance retraining using gait perturbations in individuals with moderate-to-severe traumatic brain injury

Abstract

Individuals with traumatic brain injury often present with balance problems associated with a decrease in their social participation. An innovative approach consists in using perturbations on a split-belt treadmill to improve dynamic balance. The aim of this study is to quantify the effects of a training program including perturbations on a split-belt treadmill on dynamic balance, walking speed, balance confidence and social participation in individuals with traumatic brain injury in social integration rehabilitation phase or at a chronic stage. Seven individuals with moderate-to-severe traumatic brain injury participated in six training sessions on a split-belt treadmill with self-perturbations (head movements, turns, cognitive task) and unexpected perturbations (stop-and-go, speed increase or decrease of one treadmill belt). The Mini-BESTest, Community Balance & Mobility Scale, comfortable and fast walking speed, Reintregration to Normal Living Index and Activity-Specific Balance Confidence Scale were measured twice before and after the intervention. Preliminary results indicated a statistically significant improvement of 2.1 (1.5)/28 at the Mini-BESTest and 7.0 (6.9)/96 at the Community Balance and Mobility Scale. No significant change in speed, balance confidence and social participation were observed. A learning effect was observed between the two pre-intervention assessments. This approach seems promising in balance reeducation with individuals with moderate-to-severe traumatic brain injury.