Deficits in ankle joint mechanics during running can be resolved with rehabilitation in people with traumatic brain injury.

Abstract

Background: Many people with traumatic brain injury experience difficulty running. We recently demonstrated the first-ever evidence for the recovery of lower-limb power generation for walking. The aim of this study was to determine if a period of rehabilitation could also lead to the recovery of lower-limb power generation for running. Specifically the aims were 1) To compare lower-limb joint mechanics during running for people with traumatic brain injury (TBI) to equivalent data obtained from a group of healthy controls (HC); and 2) To determine if deficits identified in biomechanical variables during running for people with TBI were responsive to a six-month period of rehabilitation. Methods: Participants: Twelve ambulant people with extremely-severe TBI who were attending physiotherapy at Epworth Healthcare for mobility limitations, and a comparative sample of 10 healthy controls (HCs). Design: Cross-sectional observational cohort study with six-month follow-up. Main Outcome Measures: Average power (i.e. over time) absorbed and generated at the hip, knee and ankle joints during stance. Results: Compared to HCs, participants with TBI at baseline ran with greater average power absorption at the hip (-0.27 W/kg vs -0.61 W/kg; p<0.05), reduced average power absorption at the knee (-2.03 W/kg vs -1.02 W/kg; p<0.05) and reduced average power generation at the ankle (2.86 W/kg vs 2.06 W/kg; p<0.05). Only average power generation at the ankle improved following six months of rehabilitation for the participants with TBI (2.06 W/kg vs 2.79 W/kg; p<0.05). Conclusion: In the cohort of participants with TBI included in the present study, recovery of running and high-level mobility was related to an improvement in ankle joint mechanics. This is the first-ever evidence for the recovery of lower-limb power generation for running in any adult or paediatric neurological population.