Assessing Physical Function and Mobility following Pediatric Traumatic Brain Injury with the NIH Toolbox Motor Battery: A Feasibility Study.
Emily A Evans, Nathan E Cook, Grant L Iverson and 2 others
PMID 32396483WHAT IT FOUND
The NIH Toolbox Motor Battery is feasible for children with traumatic brain injury, taking about 23 minutes.
It detects endurance and balance problems that parents may not report, but it fails in children under 5 due to distraction and difficulty following instructions.
Key findings
01The battery was completed in a median of 23 minutes and was well tolerated by school-aged children, though Bluetooth disconnections caused lost data in several instances.
02Children under 5 could not reliably complete the assessment because they were distracted by the iPod and could not follow the balance test instructions.
03Low endurance scores at 2 weeks were associated with lower parent and self-reported physical quality of life, but low balance scores were not associated with any reported symptoms.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study excluded children with the mildest TBI (those not requiring neuroimaging) and those with severe mobility limitations or polytrauma, so results do not apply to these groups. There was no control group or pre-injury baseline, so motor deficits cannot be definitively attributed to the TBI rather than pre-existing conditions. The sample was small (n=32) and not representative of all children with TBI, limiting the generalizability of the prevalence of 'low' performance. The test failed in children under 5, making it unsuitable for this age group without significant adaptation.
Declared interests
The authors declared no conflicts of interest or competing financial interests.
The easy way to misread this
Do not assume the NIHTB-M is valid for children under 5 or those with severe mobility impairments. The study found that young children could not reliably follow instructions or remain still, and the sample excluded patients who were non-ambulatory or had the mildest injuries.