Individuals with chronic traumatic brain injury improve walking speed and mobility with intensive mobility training.
OBJECTIVE
To determine the feasibility and impact of different dosages of Intensive Mobility Training (IMT) on mobility, balance, and gait speed in individuals with chronic traumatic brain injury (TBI).


METHODS
Prospective, single group design with 3-month follow-up.


METHODS
University research laboratory.


METHODS
Volunteer sample of participants with chronic TBI (N=10; ≥3 mo post-TBI; able to ambulate 3.05 m with or without assistance; median age, 35.4 y; interquartile range, 23.5-46 y; median time post-TBI, 9.91 y; interquartile range, 6.3-14.2 y). Follow-up data were collected for all participants.


METHODS
Twenty days (5 d/wk for 4 wk), with 150 min/d of repetitive, task-specific training equally divided among balance; gait training; and strength, coordination, and range.


METHODS
Pain and fatigue were recorded before and after each session to assess feasibility. Treatment outcomes were assessed before training (pre), after 10 sessions (interim), after 20 sessions (post), and at 3-months follow-up and included the Berg Balance Scale and gait speed.


RESULTS
Participants averaged 150.1±2.7 minutes per session. Median presession and postsession pain scores were 0 (out of 10) for 20 sessions; median presession fatigue scores ranged from 0 to 2.5 (out of 10); and postsession scores ranged from 3 to 5.5 (out of 10). Four outcome measures demonstrated significant improvement from the pretest to interim, with 7 out of 10 participants exceeding the minimal detectable change (MDC) for fast walking speed. At the posttest, 2 additional measures were significant, with more participants exceeding the MDCs. Changes in fast walking speed and Timed Up and Go test were significant at follow-up.


CONCLUSIONS
Limited fluctuations in pain and fatigue scores indicate feasibility of IMT in this population. Participants demonstrated improvements in walking speed, mobility, and balance postintervention and maintained gains in fast walking speed and mobility at 3 months.
Physical Therapy Program, Department of Exercise Science, University of South Carolina, Columbia, SC. Electronic address: petersd20@gmail.com.
Denise M
DM
Peters
Division of Biostatistics and Bioinformatics, Department of Family and Preventive Medicine, University of California, San Diego, San Diego, CA.
Sonia
S
Jain
Physical Therapy Program, Department of Exercise Science, University of South Carolina, Columbia, SC.
Derek M
DM
Liuzzo
Physical Therapy Program, Department of Exercise Science, University of South Carolina, Columbia, SC.
Addie
A
Middleton
Physical Therapy Program, Department of Exercise Science, University of South Carolina, Columbia, SC.
Jennifaye
J
Greene
Department of Cell Biology and Anatomy, School of Medicine, University of South Carolina, Columbia, SC.
Erika
E
Blanck
Biostatistics Research Center, University of California, San Diego, San Diego, CA.
Shelly
S
Sun
Department of Family and Preventive Medicine, University of California, San Diego, San Diego, CA; Department of Neurosciences, University of California, San Diego, San Diego, CA.
Rema
R
Raman
Physical Therapy Program, Department of Exercise Science, University of South Carolina, Columbia, SC.
Stacy L
SL
Fritz
D000328:Adult; D001930:Brain Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D002908:Chronic Disease; D005221:Fatigue / Q000209:etiology; D005240:Feasibility Studies; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D010146:Pain / Q000209:etiology; D004856:Postural Balance / Q000502:physiology; D011446:Prospective Studies; D055070:Resistance Training / Q000009:adverse effects; D013997:Time Factors; D016138:Walking / Q000502:physiology*; D055815:Young Adult
Brain injuries; Gait; Rehabilitation