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Physical Performance and Fall Risk in Persons With Traumatic Brain Injury.

Dennis Klima1, Lindsay Morgan2, Michelle Baylor3

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Summary

Individuals with moderate to severe traumatic brain injury (TBI) exhibit significant mobility deficits near rehabilitation discharge, indicating a high fall risk. These findings highlight the need for continued physical therapy to improve functional mobility post-discharge.

Keywords:
balancefallsgaitposturographytraumatic brain injury

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Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Biomechanics

Background:

  • Traumatic brain injury (TBI) causes persistent cognitive and neuromuscular deficits.
  • Mobility impairments often continue despite functional gains on the Rancho Los Amigos scale.
  • Limited research exists on physical performance in the acute phase of TBI before rehabilitation discharge.

Purpose of the Study:

  • To compare balance and gait performance in ambulant individuals with moderate to severe TBI nearing discharge against age-matched controls.
  • To assess performance against established thresholds for fall risk and community navigation capabilities.

Main Methods:

  • A cross-sectional study involving 40 participants (20 TBI, 20 controls).
  • Participants completed the Timed Up and Go (TUG), gait velocity, and Walking and Remembering tests.
  • Balance was assessed using the Fullerton Advanced Balance Scale (FABS) and instrumented Modified Clinical Test for Sensory Interaction in Balance (MCTSIB).

Main Results:

  • Individuals with TBI showed significantly poorer performance on all mobility tests (p < .05).
  • TBI group exhibited slower gait velocity (p < .001) and longer TUG times (p < .001).
  • TBI participants had greater sway velocity on MCTSIB (p < .01) and lower FABS scores (p < .001), indicating fall risk.

Conclusions:

  • Individuals with moderate to severe TBI nearing rehabilitation discharge demonstrate significant impairments in balance and gait.
  • Performance metrics suggest a heightened risk of falls and compromised community navigation.
  • These findings underscore the necessity for ongoing physical interventions to enhance functional mobility before and after discharge.