An assessment of gait and balance deficits after traumatic brain injury.
OBJECTIVE
To assess the sensations of instability that many patients report after traumatic brain injury (TBI).


METHODS
A controlled study.


METHODS
A motion analysis and vestibular and balance laboratory.


METHODS
Twenty subjects, 10 with TBI and complaints of instability, and 10 without TBI.


METHODS
Balance and gait analysis.


METHODS
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+/-23.0 vs 0.2+/-0.63, P<.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+/-35.8 vs 79.5+/-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.
Basford
Jeffrey R
JR
Department of Physical Medicine and Rehabilitation, Mayo Clinic and Foundation, Rochester, MN 55905, USA.
Chou
Li-Shan
LS
Kaufman
Kenton R
KR
Brey
Robert H
RH
Walker
Ann
A
Malec
James F
JF
Moessner
Anne M
AM
Brown
Allen W
AW
D000293:Adolescent; D000328:Adult; D000368:Aged; D001309:Auditory Threshold; D001696:Biomechanical Phenomena; D001930:Brain Injuries / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D003710:Demography; D004185:Disability Evaluation; D004244:Dizziness / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D015600:Glasgow Coma Scale; D023261:Glasgow Outcome Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D004856:Postural Balance; D011187:Posture; D011237:Predictive Value of Tests; D012678:Sensation Disorders / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D014724:Vestibular Function Tests