Research Reports - Postural impairments in children with mild traumatic brain injury

J Head Trauma Rehabil. 2015 Nov 17. [Epub ahead of print]

Rhine T(1), Quatman-Yates C, Clark RA.

OBJECTIVE: To examine how postural control changes following pediatric mild
traumatic brain injury.
SETTING: Urban pediatric emergency department.
PARTICIPANTS: Children 11 to 16 years old who presented within 6 hours of
sustaining mild traumatic brain injury.
DESIGN: Prospective observational cohort followed for 1 month.
MAIN MEASURES: Total center of pressure path velocity and path velocity within
distinct frequency bands, ranging from moderate to ultralow, were recorded by the
Nintendo Wii Balance Board during a 2-legged stance. Measurements were recorded
in 2 separate tests with eyes open and closed. The scores of the 2 tests were
compared, and a Romberg quotient was computed.
RESULTS: Eleven children were followed for 1 month postinjury. The ultralow
frequency, which reflects slow postural movements associated with exploring
stability boundaries, was lower (p = .02) during the eyes closed stance acutely
following injury. The Romberg quotient for this frequency was also significantly
lower acutely following injury (p = .007) than at 1 month.
CONCLUSION: Following mild traumatic brain injury, children acutely demonstrate
significantly more rigid sway patterns with eyes closed than with eyes open,
which were highlighted by the Romberg quotient. The Romberg quotient could allow
for accurate identification and tracking of postural instability without
requiring knowledge of preinjury balance ability. 

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