Krithika Sambasivan1, Lisa Grilli2, Isabelle Gagnon2. 1. School of Physical and Occupational Therapy, McGill University, Montreal, PQ, Canada. 2. Montreal Children's Hospital, McGill University Health Center, Montreal, PQ, Canada.
Abstract
PURPOSE: To compare the ability of clinical balance measures to detect differences between children recovered from a mild Traumatic Brain Injury (mTBI) and healthy controls. METHODS: A cross-sectional study, with twenty-six children with mTBI and twenty-two age-matched controls was conducted. Balance was evaluated on three scales: Bruininks- Osteresky Test-second edition; Balance Error Scoring System and Community Balance and Mobility Scale, along with gait analysis of three paradigms (self-selected paced walking, obstacle crossing and tandem walking), under single and dual-task conditions, using GAITRite\scriptsize® walkway. Independent sample t-tests (α = 0.05) were used to identify group differences. Dual-Task Cost (DTC) was analyzed using repeated measures ANOVA and t-tests. Discriminant analysis predicted which balance measure best identified the groups. RESULTS: Children with mTBI performed worse on all balance scales (p< 0.05). Gait parameters were significantly better for the controls. There were no group differences on the motor and cognitive DTC. The Community Balance and Mobility Scale and gait parameters including velocity at obstacle crossing and parameters for tandem walking, best discriminated the groups. CONCLUSION: Clinical balance assessments may need to include static and dynamic measures, to capture possible performance difficulties. The inclusion of these measures will enhance clinical decision making and prevent premature return to physical activities in children with mTBI.
PURPOSE: To compare the ability of clinical balance measures to detect differences between children recovered from a mild Traumatic Brain Injury (mTBI) and healthy controls. METHODS: A cross-sectional study, with twenty-six children with mTBI and twenty-two age-matched controls was conducted. Balance was evaluated on three scales: Bruininks- Osteresky Test-second edition; Balance Error Scoring System and Community Balance and Mobility Scale, along with gait analysis of three paradigms (self-selected paced walking, obstacle crossing and tandem walking), under single and dual-task conditions, using GAITRite\scriptsize® walkway. Independent sample t-tests (α = 0.05) were used to identify group differences. Dual-Task Cost (DTC) was analyzed using repeated measures ANOVA and t-tests. Discriminant analysis predicted which balance measure best identified the groups. RESULTS:Children with mTBI performed worse on all balance scales (p< 0.05). Gait parameters were significantly better for the controls. There were no group differences on the motor and cognitive DTC. The Community Balance and Mobility Scale and gait parameters including velocity at obstacle crossing and parameters for tandem walking, best discriminated the groups. CONCLUSION: Clinical balance assessments may need to include static and dynamic measures, to capture possible performance difficulties. The inclusion of these measures will enhance clinical decision making and prevent premature return to physical activities in children with mTBI.
Entities:
Keywords:
Balance; Mild Traumatic Brain Injury; children and adolescents; concussion; mobility or gait
Authors: Nicholas G Murray; Ryan Moran; Arthur Islas; Phillip Pavilionis; Brian Szekely; Sushma Alphonsa; David Howell; Thomas Buckley; Daniel Cipriani Journal: J Clin Transl Res Date: 2021-07-16
Authors: Emily A Evans; Nathan E Cook; Grant L Iverson; Elise L Townsend; Ann-Christine Duhaime Journal: Phys Occup Ther Pediatr Date: 2020-05-12 Impact factor: 2.360