Mark A Newman1, Mark A Hirsch2, Richard D Peindl3, Nahir A Habet3, Tobias J Tsai2, Michael S Runyon4, Toan Huynh5, Christian Phillips2, Nigel Zheng6. 1. Carolinas Medical Center, Carolinas Rehabilitation, Department of Physical Medicine and Rehabilitation, 1100 Blythe Blvd. Charlotte, NC 28203, United States. Electronic address: Mark.Newman@atriumhealth.org. 2. Carolinas Medical Center, Carolinas Rehabilitation, Department of Physical Medicine and Rehabilitation, 1100 Blythe Blvd. Charlotte, NC 28203, United States. 3. Atrium Health Musculoskeletal Institute, 1000 Blythe Blvd. Charlotte, NC 28203, United States. 4. Carolinas Medical Center, Department of Emergency Medicine, 1000 Blythe Blvd. Charlotte, NC 28203, United States. 5. Carolinas Medical Center, Department of Surgery, Division of Acute Care Surgery, 1000 Blythe Blvd. Charlotte, NC 28203, United States. 6. Center for Biomedical Engineering and Science, University of North Carolina at Charlotte, 9201 University City Blvd Charlotte, NC 28223, United States.
Abstract
BACKGROUND: Wearable sensors have allowed researchers to instrument tests of gait-related mobility, including the widely used timed 'up-and-go' test (TUG). Currently, there is a lack of instrumented test data on whether children with moderate to severe traumatic brain injury (TBI) perform differently on the TUG compared to typically developed (TD) controls during a cognitive-motor task. RESEARCH QUESTION: The aim was to explore the effects of a cognitive-motor task on TUG subcomponents among children with TBI compared to TD children. METHODS: This observational cross-sectional study included 12 children with moderate to severe TBI (6 males and 6 females, age 10.5 ± 1.5 years of age) and 10 age and sex-matched TD controls (5 males and 5 females, 10.4 ± 1.3 years of age). Each participant completed 6 trials of the TUG wearing a single inertial measurement unit sensor at a self-selected walking pace while listening to an array of 10 randomly presented single digits during each TUG trial. RESULTS: Total time to complete the TUG was not significantly different between groups. The cognitive-motor task led to significantly lower mean turn and peak turn angular velocity values during the turn-around-the-cone and turn-before-sitting TUG subcomponents in children with TBI compared to the TD controls (p ≤ 0.05). Additionally, the cognitive-motor task led to significantly lower values for maximum torso flexion to extension angle, peak flexion and extension angular velocity and peak vertical acceleration for the sit-to-stand subcomponent (p < 0.05). Peak flexion angular velocity during the stand-to-sit subcomponent was lower for the TBI group compared to the children with TD (p < 0.05). SIGNIFICANCE: The study provides new insights into the performance of complex gait-related mobility tasks in the context of an instrumented TUG among children with moderate to severe TBI. Our results highlight the potential benefits of outfitting pediatric inpatients with an IMU while completing the TUG.
BACKGROUND: Wearable sensors have allowed researchers to instrument tests of gait-related mobility, including the widely used timed 'up-and-go' test (TUG). Currently, there is a lack of instrumented test data on whether children with moderate to severe traumatic brain injury (TBI) perform differently on the TUG compared to typically developed (TD) controls during a cognitive-motor task. RESEARCH QUESTION: The aim was to explore the effects of a cognitive-motor task on TUG subcomponents among children with TBI compared to TD children. METHODS: This observational cross-sectional study included 12 children with moderate to severe TBI (6 males and 6 females, age 10.5 ± 1.5 years of age) and 10 age and sex-matched TD controls (5 males and 5 females, 10.4 ± 1.3 years of age). Each participant completed 6 trials of the TUG wearing a single inertial measurement unit sensor at a self-selected walking pace while listening to an array of 10 randomly presented single digits during each TUG trial. RESULTS: Total time to complete the TUG was not significantly different between groups. The cognitive-motor task led to significantly lower mean turn and peak turn angular velocity values during the turn-around-the-cone and turn-before-sitting TUG subcomponents in children with TBI compared to the TD controls (p ≤ 0.05). Additionally, the cognitive-motor task led to significantly lower values for maximum torso flexion to extension angle, peak flexion and extension angular velocity and peak vertical acceleration for the sit-to-stand subcomponent (p < 0.05). Peak flexion angular velocity during the stand-to-sit subcomponent was lower for the TBI group compared to the children with TD (p < 0.05). SIGNIFICANCE: The study provides new insights into the performance of complex gait-related mobility tasks in the context of an instrumented TUG among children with moderate to severe TBI. Our results highlight the potential benefits of outfitting pediatric inpatients with an IMU while completing the TUG.