Craniectomy and Cranioplasty Effects on Balance and Gait in Rehabilitation: A Retrospective Study

To analyze changes in balance and gait in patients undergoing rehabilitation postcraniectomy and postcranioplasty, including comparison of outcomes across time periods, rate of change, and among diagnoses.

Retrospective cohort study.

Inpatient rehabilitation.

Fifty-three patients (mean age 52.3±16.9y; 62% male) with stroke, traumatic, or nontraumatic brain injury postcraniectomy or postcranioplasty.

Not applicable.

Berg Balance Scale (BBS), Functional Gait Assessment (FGA), 6-minute walk test (6MWT), and 10-meter walk test (10MWT) were collected at baseline, first discharge, readmission, and final discharge.

Across the full rehabilitation course, all 4 outcomes improved: BBS, 17.9 points (95% confidence interval [CI], 12.7-23.2); FGA, 7.8 points (95% CI, 0.6-15.0); 6MWT, 141.0 m (95% CI, 89.0-192.0); and 10MWT, 0.381 m/s (95% CI, 0.188-0.575). All outcomes improved at postcraniectomy admission: BBS, 13.0 points (95% CI, 8.4-17.5); FGA, 4.0 points (95% CI. -1.65 to 9.65); 6MWT, 100.0 m (95% CI, 58.2-142.0); and 10MWT, 0.160 m/s (95% CI, 0.004-0.316). During leave of absence from rehabilitation, BBS decreased 6.3 points (95% CI, -11.8 to -0.8); FGA decreased 6.6 points (95% CI, -13.8 to 0.6); 6MWT decreased 19.2 m (95% CI, -73.5 to 35.2); and 10MWT increased 0.089 m/s (95% CI, -0.097 to 0.276). All outcomes improved at postcranioplasty admission: BBS, 11.3 points (95% CI, 6.6-16.0); FGA, 10.4 points (95% CI, 4.8-16.1); 6MWT, 59.4 m (95% CI, 14.1-105.0); and 10MWT, 0.132 m/s (95% CI, -0.039 to 0.303). Diagnosis was not associated with changes in outcomes.

Gait and balance outcomes improved during postcraniectomy and postcranioplasty rehabilitation admissions but not immediately post cranioplasty.