Decomposition of leg movements during overground walking in individuals with traumatic brain injury

Walking requires precise coordination of bilateral lower extremity motions at all joints. This ability can be affected by traumatic brain injury (TBI). The study investigated inter-joint coordination of lower extremities during overground walking after TBI.

Ten individuals with post-injury ataxia, postural stability and gait abnormalities, as well as 10 sex- and age-matched control subjects were involved in the study. Participants walked at self-selected speed in three experimental conditions: normal walking without any additional task; walking with a narrow base of support, and walking while holding a cup full of water. Inter-joint coordination was analysed as the percentage of gait cycle during which the leg movement was decomposed with 0% indicating simultaneous motion of the two joints (i.e. hip-knee, knee-ankle, and hip-ankle) through the entire gait cycle or 100% indicating motion of only one joint. Decomposition was calculated for each pair of joints and for the left and right leg separately.

Participants with TBI showed greater decomposition indices and poorer inter-joint coordination respectively than control individuals for all joint pairs (p < 0.01). Walking with the narrower base of support or with a cup, increased movement decomposition in the TBI group, but not in the control group.

The results revealed post-injury gait impairment that manifests as decomposition of multi-joint motions of the lower extremities during overground walking.