High Intensity Gait Training in Anoxic Brain Injury: A Case Study

Abstract

<h3>Research Objectives</h3> To investigate the effectiveness of high intensity gait training (HIGT) intervention in sub acute anoxic brain injury. The literature suggests this intervention strategy may facilitate an individual's return to function, however a paucity of research exists supporting the use of HIGT for rehabilitation post-anoxic brain injury. <h3>Design</h3> Single case study before-after trial. <h3>Setting</h3> Inpatient rehabilitation at a Level 1 Trauma Center. <h3>Participants</h3> One 24-year old male with anoxic brain injury. <h3>Interventions</h3> Treadmill training and over ground training were performed for a maximum of 30 minutes per session throughout ten days of inpatient rehabilitation. Harness support at 0% bodyweight was utilized on the treadmill to ensure safety. Heart rate was monitored via continuous pulse oximetry with a goal of reaching 70-80% of the participant's age adjusted maximum heart rate. HIGT was achieved by varying speed, increasing incline, and incorporating forward, backward, and lateral stepping. <h3>Main Outcome Measures</h3> Two functional outcome measures were chosen to assess the participant's gait speed and fall risk at admission and discharge. This included Ten Meter Walk Test (10MWT) and Berg Balance Scale (BBS). Minimal detectable change (MDC) for non-traumatic brain injuries was used to evaluate meaningful improvement. <h3>Results</h3> Meaningful change was achieved in the 10MWT comfortable pace (D 0.37sec; MDC 0.18 m/s) and fast pace (D 0.48 sec; MDC 0.13 m/s) and BBS (D 22 points; MDC 4.66 points). Progression from non-ambulatory to household ambulation with assistance was achieved at discharge. <h3>Conclusions</h3> HIGT is a promising intervention for meaningful functional improvement for individuals with anoxic brain injury. Further studies are necessary to validate this finding. No adverse events occurred with HIGT in sub acute anoxic brain injury. <h3>Author(s) Disclosures</h3> The authors declare that they have no financial or personal relationships that relate to the research described in this paper.