Craniectomy and Cranioplasty Effects on Balance and Gait in Rehabilitation: A Retrospective Study.
Leandra A Stuckey, Elizabeth E Holland, Miranda G Gurra and 2 others
PMID 39822205WHAT IT FOUND
Balance and walking improved over rehabilitation, but the study did not show that cranioplasty alone improved them.
Berg Balance Scale scores fell between admissions, then rose again during postcranioplasty therapy.
Key findings
01From baseline to final discharge, all measures improved: Berg Balance Scale 17.9 points, Functional Gait Assessment 7.8 points, 6 minute walk test 141.0 m, and 10 meter walk test 0.381 m/s.
02Between first discharge and readmission, the Berg Balance Scale decreased 6.3 points, while the Functional Gait Assessment, 6 minute walk test, and 10 meter walk test changes were not statistically significant.
03After adjusting for length of stay, no outcome showed a significant difference between the postcraniectomy and postcranioplasty admissions.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This was a retrospective record review with no comparison group of similar patients who did not have craniectomy or cranioplasty. Outcome measures were not completed by everyone at every time point: the Berg Balance Scale had 46 participants, the Functional Gait Assessment had 9, the 10 meter walk test had 33, and the 6 minute walk test had 48. The Functional Gait Assessment analysis had only 9 participants, and only patients with traumatic or nontraumatic brain injury completed it. Table 1 counts 54 admissions because one participant was coded with traumatic and nontraumatic brain injury at separate admissions, while the participant count is 53. The study used stroke data to judge clinical difference for patients with traumatic or nontraumatic brain injury because no specific minimal detectable change values were available for those groups.
Declared interests
The authors declared no conflicts.
The easy way to misread this
Do not conclude that cranioplasty itself improves balance or walking. The study found no significant difference between the postcraniectomy and postcranioplasty rehabilitation phases after adjusting for length of stay, and it cannot separate cranioplasty from rehabilitation because all participants were in inpatient rehabilitation.