Trunk sway in patients with and without, mild traumatic brain injury after whiplash injury

Abstract

Objective This study assessed the addition effect of mild traumatic brain injury (MTBI) on the balance control of patients who simultaneously suffered a whiplash associated disorder (WAD). Background Dizziness is common in patients suffering from whiplash injury with or without a MTBI, but data is lacking about the additional balance problems and dizziness caused by MTBI. Methods 44 patients with WAD and MTBI and 36 WAD patients without MTBI participated in the study. A dizziness handicap index (DHI) was used to quantify self-perceived handicap. Balance control was assessed using measures of trunk sway for a battery of stance and gait tests. Results Patients with WAD and MTBI perceived significantly higher dizziness and unsteadiness (higher score in DHI Emotional category) and had greater trunk sway than WAD patients without MTBI for stance tasks and complex gait tasks (e.g. walking up and down stairs). Both groups had greater sway than controls for these tasks. Both groups of patients showed equal reductions in trunk sway with respect to controls for simple gait tasks (e.g. walking while rotating the head). Conclusions A similar pattern of balance impairment was present in patients with whiplash injury with and without MTBI. However, the impairment was greater for stance and complex gait tasks in WAD patients with MTBI.