title: An assessment of gait and balance deficits after traumatic brain injury.
abstract: 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.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Mayo Clinic and Foundation, Rochester, MN 55905, USA.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Basford
authors.forename: Li-Shan
authors.initials: LS
authors.lastname: Chou
authors.forename: Kenton R
authors.initials: KR
authors.lastname: Kaufman
authors.forename: Robert H
authors.initials: RH
authors.lastname: Brey
authors.forename: Ann
authors.initials: A
authors.lastname: Walker
authors.forename: James F
authors.initials: JF
authors.lastname: Malec
authors.forename: Anne M
authors.initials: AM
authors.lastname: Moessner
authors.forename: Allen W
authors.initials: AW
authors.lastname: Brown
mesh_terms: 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