Is there a relationship between postural alignment and mobility for adults after acquired brain injury? A systematic review.
OBJECTIVE
To examine the relationship between postural alignment and mobility skills for adults after acquired brain injury (ABI).


METHODS
Systematic review of the literature. Seven electronic databases, grey literature and reference lists of the shortlisted publications were searched. Studies were included if participants were adults with ABI, both postural alignment and mobility were measured and analysis included a relationship between alignment and mobility. Those that met the inclusion criteria were assessed with a critical appraisal tool. The review was registered with PROSPERO, registration number CRD42015019867.


RESULTS
Seven observational studies were included that had examined a relationship between postural alignment and mobility after ABI. Critical appraisal scores were moderate to strong. While some studies reported that improved postural alignment was related to improved mobility after ABI, results varied and there was insufficient evidence to answer the primary question. Heterogeneous study designs did not allow meta-regression.


CONCLUSIONS
A small amount of observational evidence exists for a relationship between postural alignment and mobility after ABI. Results vary, with some studies reporting that a more stable, upright trunk correlates with better mobility, and others providing conflicting or ambiguous results. Further research is needed to establish the relationship between postural alignment and mobility skills after ABI.
a South Australian Brain Injury Rehabilitation Service, Hampstead Rehabilitation Centre , Adelaide , SA , Australia.|b International Centre for Allied Health Evidence (iCAHE).
Simon J
SJ
Mills
c Alliance for Research in Exercise , Nutrition and Activity (ARENA).
Michelle N
MN
McDonnell
c Alliance for Research in Exercise , Nutrition and Activity (ARENA).
Dominic
D
Thewlis
d Sansom Institute for Health Research, University of South Australia , Adelaide , SA , Australia.
Shylie
S
Mackintosh
D000328:Adult; D001930:Brain Injuries / Q000150:complications*; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D006801:Humans; D009069:Movement Disorders / Q000209:etiology*; D004856:Postural Balance / Q000502:physiology*; D012678:Sensation Disorders / Q000209:etiology*
Head injury; posture; standing; stroke; trunk; walking