Improved ambulation and speech production in an adolescent post-traumatic brain injury through a therapeutic intervention to increase postural control.

PURPOSE: This case study examined the effectiveness of a programme designed to improve anticipatory postural control in an adolescent over years 2 and 3 post-traumatic brain injury (TBI). It was hypothesized that her difficulty in walking and talking simultaneously was caused by excessive co-activation of extremity, trunk, and oral musculature during upright activities.
METHODS: The participant was treated weekly by physical and speech therapy. Treatment focussed on improving anticipatory postural control during gross motor activities in conjunction with oral-motor function.
RESULTS: Initially, the participant walked using a walker at a speed of 23 cm s(-1). Two years later, she could walk without a device at 53 cm s(-1). Initial laryngoscopic examination showed minimal movement of the velum or pharyngeal walls; full movement was present after treatment. The measure of intelligibility improved from no single word intelligible utterances to 85% intelligible utterances after 2 years. DISCUSSION: The results suggest that less compensatory rigidification of oral musculature was needed to maintain an upright position against gravity as postural control improved.
CONCLUSION: An adolescent 1-year post-TBI was followed as she underwent additional rehabilitation focussed on improving anticipatory postural control. The functional goal of simultaneously talking while walking was achieved through this intervention.