Research Reports - Balance and mobility in clinically recovered children and adolescents after a mild traumatic brain injury

J Pediatr Rehabil Med. 2015 Dec 1;8(4):335-44. doi: 10.3233/PRM-150351.

Sambasivan K(1), Grilli L(2), Gagnon I(2).

PURPOSE: To compare the ability of clinical balance measures to detect
differences between children recovered from a mild Traumatic Brain Injury (mTBI)
and healthy controls.
METHODS: A cross-sectional study, with twenty-six children with mTBI and
twenty-two age-matched controls was conducted. Balance was evaluated on three
scales: Bruininks- Osteresky Test-second edition; Balance Error Scoring System
and Community Balance and Mobility Scale, along with gait analysis of three
paradigms (self-selected paced walking, obstacle crossing and tandem walking),
under single and dual-task conditions, using GAITRite\scriptsize® walkway.
Independent sample t-tests (α = 0.05) were used to identify group differences.
Dual-Task Cost (DTC) was analyzed using repeated measures ANOVA and t-tests.
Discriminant analysis predicted which balance measure best identified the groups.
RESULTS: Children with mTBI performed worse on all balance scales (p< 0.05). Gait
parameters were significantly better for the controls. There were no group
differences on the motor and cognitive DTC. The Community Balance and Mobility
Scale and gait parameters including velocity at obstacle crossing and parameters
for tandem walking, best discriminated the groups.
CONCLUSION: Clinical balance assessments may need to include static and dynamic
measures, to capture possible performance difficulties. The inclusion of these
measures will enhance clinical decision making and prevent premature return to
physical activities in children with mTBI. 

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