Relating Self-Reported Balance Problems to Sensory Organization and Dual-Tasking in Chronic Traumatic Brain Injury.
Annie-Lori C Joseph, Sara M Lippa, Brian Moore and 4 others
PMID 32844594WHAT IT FOUND
At least one year after TBI, a standing vestibular balance test did not explain reported balance problems.
Walking while subtracting did: worse walking during the mental task was linked to greater reported balance handicap, after accounting for depression and gender.
Key findings
01Sensory Organization Test vestibular scores did not differ significantly between symptomatic and asymptomatic groups and did not predict Dizziness Handicap Inventory total scores.
02Worse gait percent cost during walking while subtracting was associated with greater Dizziness Handicap Inventory total scores after depression and gender were accounted for.
03Participants who reported dizziness or loss of balance had more neurobehavioral symptoms, greater perceived balance handicap, and more depression symptoms than those who did not.
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 cross-sectional analysis of 50 people, so it shows association but not cause. The sample was small for regression, and data were missing for seven Dizziness Handicap Inventory cases and seven Sensory Organization Test cases; one participant was removed from cognitive analyses. Groups differed in TBI severity: mild and severe cases were more common in the symptomatic group, and moderate cases were more common in the asymptomatic group. Time since injury varied from one to four years, so the findings do not pin to a specific chronic stage. Antidepressant use was higher in the symptomatic group, and medications can affect balance, cognition, and mood. Self-report measures may be affected by impaired awareness after TBI. The study compared symptomatic and asymptomatic people with TBI, not people without TBI.
Declared interests
The paper is listed as NIH intramural research support. The supplied text does not include a separate conflict-of-interest declaration.
The easy way to misread this
Do not read the dual-task association as evidence that dual-task training helps. This study did not test treatment; it only related worse walking during a mental task to greater reported balance handicap.