Spatiotemporal deficits and kinematic classification of gait followed by a TBI: A systematic review.

Abstract

OBJECTIVE: To identify the key biomechanical gait abnormalities resulting from traumatic brain injury (TBI) and determine whether the abnormalities support a system for the classification of gait disorders. DESIGN: Systematic review with data from quantitative studies synthesized in a narrative format. PARTICIPANTS: Adults with TBI. OUTCOME MEASURES: Spatiotemporal, kinematic, and kinetic parameters of classification systems. RESULTS: The search identified 38 articles that reported on various methods for gait assessment in TBI. Three-dimensional gait analysis (3DGA) was used in 15 studies, primarily to quantify spatiotemporal parameters. Results revealed that people with a TBI walked more slowly with shorter steps and greater mediolateral sway following TBI. Stepping over obstacles, walking with eyes closed, or performing dual tasks accentuated gait deficits. Only one small study reported kinematic data for the major lower limb joints in 8 well recovered patients. One further study used 3DGA to classify the gait patterns of people with TBI but this classification was based on methods developed for stroke and cerebral palsy. No studies attempted to develop a classification system on the basis of the gait disorders of people with TBI. CONCLUSION: Although the studies were generally of high quality, little is known about the nature of gait disorders following TBI. Classification based on systematic description of gait disorders following TBI has not been attempted.