title: High-level mobility in chronic traumatic brain injury and its relationship with clinical variables and magnetic resonance imaging findings in the acute phase.
abstract: OBJECTIVE
  To compare high-level mobility in individuals with chronic moderate-to-severe traumatic brain injury (TBI) with matched healthy controls, and to investigate whether clinical variables and magnetic resonance imaging (MRI) findings in the acute phase can predict high-level motor performance in the chronic phase.
  
  
  METHODS
  A longitudinal follow-up study.
  
  
  METHODS
  A level 1 trauma center.
  
  
  METHODS
  Individuals (N=136) with chronic TBI (n=65) and healthy matched peers (n=71).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  High-Level Mobility Assessment Tool (HiMAT) and the revised version of the HiMAT performed at a mean of 2.8 years (range, 1.5-5.4y) after injury.
  
  
  RESULTS
  Participants with chronic TBI had a mean HiMAT score of 42.7 (95% confidence interval [CI], 40.2-45.2) compared with 47.7 (95% CI, 46.1-49.2) in the control group (P<.01). Group differences were also evident using the revised HiMAT (P<.01). Acute-phase clinical variables and MRI findings explained 58.8% of the variance in the HiMAT score (P<.001) and 59.9% in the revised HiMAT score (P<.001). Lower HiMAT scores were associated with female sex (P=.031), higher age at injury (P<.001), motor vehicle collisions (P=.030), and posttraumatic amnesia >7 days (P=.048). There was a tendency toward an association between lower scores and diffuse axonal injury in the brainstem (P=.075).
  
  
  CONCLUSIONS
  High-level mobility was reduced in participants with chronic, either moderate or severe TBI compared with matched peers. Clinical variables in the acute phase were significantly associated with high-level mobility performance in participants with TBI, but the role of early MRI findings needs to be further investigated. The findings of this study suggest that the clinical variables in the acute phase may be useful in predicting high-level mobility outcome in the chronic phase.
authors.affiliation: Stiftelsen CatoSenteret, Department of Medical Rehabilitation Services, Son, Norway. Electronic address: kine.therese.moen@gmail.com.
authors.forename: Kine Therese
authors.initials: KT
authors.lastname: Moen
authors.affiliation: Department of Health and Care Sciences and the Tromsø Endocrine Research Group, University of Tromsø, Tromsø, Norway; Department of Clinical Therapeutic Services, University Hospital of North Norway, Tromsø, Norway.
authors.forename: Lone
authors.initials: L
authors.lastname: Jørgensen
authors.affiliation: Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Alexander
authors.initials: A
authors.lastname: Olsen
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Asta
authors.initials: A
authors.lastname: Håberg
authors.affiliation: Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Toril
authors.initials: T
authors.lastname: Skandsen
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway; Department of Neurosurgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
authors.forename: Anne
authors.initials: A
authors.lastname: Vik
authors.affiliation: Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Ann-Mari
authors.initials: AM
authors.lastname: Brubakk
authors.affiliation: Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway; Department of Physiotherapy, Trondheim Municipality, Norway.
authors.forename: Kari Anne I
authors.initials: KA
authors.lastname: Evensen
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000647:Amnesia / Q000209:etiology; D020208:Brain Injury, Chronic / Q000150:complications / Q000503:physiopathology*; D016022:Case-Control Studies; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D059907:Functional Neuroimaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D012737:Sex Factors; D015599:Trauma Severity Indices; D016138:Walking / Q000502:physiology*; D055815:Young Adult
keywords: Diffuse axonal injury; Magnetic resonance imaging; Motor skills; Rehabilitation