PTCohortJournal of neuroengineering and rehabilitation2022

Free-living gait does not differentiate chronic mTBI patients compared to healthy controls.

Dylan Powell, Alan Godfrey, Lucy Parrington and 3 others

PMID 35619112

WHAT IT FOUND

People with chronic mild TBI and self-reported balance problems walked no differently in daily life than healthy controls over up to 7 days of sensor wear.

A waist sensor did not separate the groups.

Key findings

01After age and sex were controlled, daily-life walking measures did not differ significantly between chronic mild TBI patients and controls.

02The daily-life walking measures were poor at telling chronic mild TBI patients from controls.

03The chronic mild TBI group remained symptomatic more than 3 months after injury.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

No power calculation was done, and the study was exploratory with opportunistic sampling. The chronic mild TBI group were more than 3 months post-injury, with a median of 1.2 years, so they may have developed compensatory walking patterns. Balance problems were self-reported, and no baseline objective measure of impairment was used. The symptom questionnaire was completed only by the mild TBI group, so symptom severity could not be compared with controls. Wear time varied and some participants wore the sensor for as little as 3 days, which may not reflect true habitual mobility. The study did not know the environments, surfaces or terrain people walked on, and a single waist sensor cannot measure step width or other characteristics. The outcome measures are primarily research-orientated and require time-consuming post-processing. Controls only needed no brain injury in the last year, not a lifelong absence of brain injury.

Declared interests

The supplied text lists funding from a private physiotherapy education foundation and fund, the Assistant Secretary of Defense for Health Affairs, Northumbria University, and the Parkinson's Foundation. It gives no author conflict-of-interest declaration.

The easy way to misread this

Do not conclude that chronic mild TBI patients have normal gait. This was an exploratory study with no power calculation, and it measured only ordinary daily walking over up to 7 days, so it cannot rule out deficits under more challenging tasks or in turning.

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