title: Balance and mobility in clinically recovered children and adolescents after a mild traumatic brain injury.
abstract: OBJECTIVE
  To compare the ability of clinical balance measures to detect differences between children recovered from a mild Traumatic Brain Injury (mTBI) and healthy controls.
  
  
  METHODS
  A cross-sectional study, with twenty-six children with mTBI and twenty-two age-matched controls was conducted. Balance was evaluated on three scales: Bruininks- Osteresky Test-second edition; Balance Error Scoring System and Community Balance and Mobility Scale, along with gait analysis of three paradigms (self-selected paced walking, obstacle crossing and tandem walking), under single and dual-task conditions, using GAITRite\scriptsize® walkway. Independent sample t-tests (α = 0.05) were used to identify group differences. Dual-Task Cost (DTC) was analyzed using repeated measures ANOVA and t-tests. Discriminant analysis predicted which balance measure best identified the groups.
  
  
  RESULTS
  Children with mTBI performed worse on all balance scales (p< 0.05). Gait parameters were significantly better for the controls. There were no group differences on the motor and cognitive DTC. The Community Balance and Mobility Scale and gait parameters including velocity at obstacle crossing and parameters for tandem walking, best discriminated the groups.
  
  
  CONCLUSIONS
  Clinical balance assessments may need to include static and dynamic measures, to capture possible performance difficulties. The inclusion of these measures will enhance clinical decision making and prevent premature return to physical activities in children with mTBI.
authors.affiliation: School of Physical and Occupational Therapy, McGill University, Montreal, PQ, Canada.
authors.forename: Krithika
authors.initials: K
authors.lastname: Sambasivan
authors.affiliation: Montreal Children's Hospital, McGill University Health Center, Montreal, PQ, Canada.
authors.forename: Lisa
authors.initials: L
authors.lastname: Grilli
authors.affiliation: Montreal Children's Hospital, McGill University Health Center, Montreal, PQ, Canada.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Gagnon
mesh_terms: D000293:Adolescent; D001930:Brain Injuries / Q000503:physiopathology*; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D004856:Postural Balance; D011446:Prospective Studies; D016138:Walking
keywords: Balance; Mild Traumatic Brain Injury; children and adolescents; concussion; mobility or gait