Classification of gait disorders following traumatic brain injury

To determine the extent to which gait disorders associated with traumatic brain injury (TBI) are able to be classified into clinically relevant and distinct subgroups.

Cross-sectional cohort study comprising people with TBI receiving physiotherapy for mobility limitations.

One hundred two people with TBI.

The taxonomic framework for gait disorders following TBI was devised on the basis of a framework previously developed for people with cerebral palsy. Participants with TBI who were receiving therapy for mobility problems were assessed using 3-dimensional gait analysis. Pelvis and bilateral lower limb kinematic data were recorded using a VICON motion analysis system while each participant walked at a self-selected speed. Five trials of data were collected for each participant. Multiclass support vector machine models were developed to systematically and automatically ascertain the clinical classification.

The statistical features derived from the major joint angles from unaffected limbs contributed to the best classification accuracy of 82.35% (84 of the 102 subjects). Features from the affected limb resulted in a classification accuracy of 76.47% (78 of 102 subjects).

Despite considerable variability in gait disorders following TBI, we were able to generate a clinical classification system on the basis of 6 distinct subgroups of gait deviations. Statistical features related to the motion of the pelvis, hip, knee, and ankle on the less affected leg were able to accurately classify 82% of people with TBI-related gait disorders using a multiclass support vector machine framework.