Gait during community ambulation and laboratory-based walking in people with mild traumatic brain injury.

This was a cross-sectional comparison, so it cannot show that mild TBI caused the gait differences or that the differences will change over time. The comparisons were exploratory and did not correct for testing many gait variables at once, so some findings could be chance. The community walk was 400 m and took 6 to 7 minutes, and participants were not constrained during it, which may make it hard to standardize in clinic. Wearable sensors are not widely used in most clinical settings, so the findings may not translate directly to usual care. The mild TBI group included people aged 18 to 50, more than 3 weeks but within 3 years from injury, and still reporting symptoms, so it says little about older adults, very recent or very chronic injury, or asymptomatic people. The mild TBI group had diverse injury mechanisms, which may hide deficits that would be clearer in a more homogeneous group. Only gait variables were measured, not head-trunk coordination, asymmetry, fatigue, or adaptability. Turning differences seen in the lab were not seen during the community walk, and the authors suggest this may be because the community route used smaller turns.

The authors declared no conflicts of interest. The article is listed as supported by NIH extramural research.

Do not conclude that a community ambulatory task is a ready-made clinical test for mild TBI. The sensors are not widely used, the comparisons were exploratory without multiple-comparison correction, and the study did not test whether fixing these gait changes improves symptoms or function.