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Title: Mobility following TBI: relationships with ankle joint power generation and motor skill level.
Epworth Authors: Williams, Gavin
Other Authors: Schache, Anthony
Morris, Meg
Keywords: Physiotherapy Department, Epworth Hospital, Richmond, Victoria, Australia
Brain Injuries
Brain Injuries, Traumatic
Traumatic Brain Injury
Trauma, Brain
Victorian Neurotrauma Initiative
Ankle Joint
Motor Skills
Postural Balance
Balance, Postural
Musculoskeletal Equilibrium
Postural Equilibrium
Muscle Spasticity
Muscle Weakness
Mobility Limitation
Ambulation Difficulty
Difficulty Walking
Issue Date: Sep-2013
Publisher: Wolters Kluwer
Citation: Journal of Head Trauma Rehabilitation 2013, 28 (5): 371-378
Abstract: BACKGROUND: Reduced balance, spasticity, contractures, muscle weakness, and motor skill levels may all contribute to mobility limitations after traumatic brain injury (TBI), yet the key physical impairments that contribute to mobility limitations remain unclear. OBJECTIVE: The aim of this study was to determine which physical impairments best predict mobility performance after a period of 6 months of rehabilitation. PARTICIPANTS: Participants with TBI were selected if they were receiving therapy for mobility limitations but were able to walk without physical assistance. OUTCOME MEASURES: The clinical assessment included measures of balance, spasticity, and contracture, and 3-dimensional quantitative gait analysis was used to quantify joint power generation and motor skill level on 31 adults with severe TBI. Mobility outcome was quantified with the high-level mobility assessment tool. RESULTS: Two variables, ankle joint power generation during the push-off phase of gait and motor skill level, explained 66.5% of the variability in mobility outcome. Balance, strength, and mobility performance, all improved significantly over the 6 months of rehabilitation. Only 2 participants had contractures, which affected mobility. Balance disorders were prevalent and improved with rehabilitation, yet they contributed to only a limited extent to the level of recovery in mobility. CONCLUSION: Ankle joint power generation at push-off was the strongest predictor of mobility outcome after 6 months of rehabilitation in ambulant people with TBI.
DOI: 10.1097/HTR.0b013e31824a1d40
PubMed URL:
ISSN: 0885-9701
Journal Title: Journal of Head Trauma Rehabilitation
Type: Journal Article
Affiliated Organisations: School of Physiotherapy, University of Melbourne, Parkville, Victoria, Australia
Department of Mechanical Engineering, University of Melbourne, Parkville, Victoria, Australia
Type of Clinical Study or Trial: Prospective Observational Study
Appears in Collections:Rehabilitation

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