title: Effectiveness of physical therapy for improving gait and balance in individuals with traumatic brain injury: a systematic review.
abstract: OBJECTIVE
  The purpose of this review was to investigate the efficacy or effectiveness of non-aerobic exercise interventions to improve balance and gait in functionally mild-to-moderate individuals with TBI (those who demonstrate the ability or capacity to ambulate) and to provide evidence-based guidelines for clinical practice.
  
  
  METHODS
  The authors searched eight databases for papers including exercise interventions to improve gait and balance post-TBI. Twenty papers fully met inclusion criteria. The quality of studies was determined by the Physiotherapy Evidence Database (PEDro) scale and strength by Sackett's Levels of Evidence.
  
  
  RESULTS
  This study found limited evidence of the positive effects of balance, gait or the combination of both interventions in TBI rehabilitation. Most studies included small sample sizes with heterogeneous groups and the interventions were variable and lacked standardization. The outcome measures were variable and low in quality.
  
  
  CONCLUSIONS
  The state of evidence for gait and balance interventions in patients with mild-to-moderate TBI is surprisingly poor. Greater consideration and conformity in the choice of outcome measures and attention in the design and standardization treatment approaches are essential in future research to advance practice.
authors.affiliation: Functional & Applied Biomechanics Section, Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD 20892, USA.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Bland
authors.forename: Cris
authors.initials: C
authors.lastname: Zampieri
authors.forename: Diane L
authors.initials: DL
authors.lastname: Damiano
mesh_terms: D001930:Brain Injuries / Q000534:rehabilitation*; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D009460:Neurologic Examination; D026741:Physical Therapy Modalities / Q000592:standards*; D004856:Postural Balance; D020127:Recovery of Function / Q000502:physiology*; D012678:Sensation Disorders / Q000534:rehabilitation; D016896:Treatment Outcome