Assessment of balance in people with mild traumatic brain injury using a balance systems model approach.

Autor: Campbell KR; Department of Neurology, Balance Disorders Laboratory, Oregon Health & Science University, Portland, USA; National Center for Rehabilitative Auditory Research (NCRAR), VA Portland Health Care System, Portland, USA. Electronic address: campbeko@ohsu.edu., Scanlan KT; Department of Neurology, Balance Disorders Laboratory, Oregon Health & Science University, Portland, USA., Wilhelm JL; Department of Neurology, Balance Disorders Laboratory, Oregon Health & Science University, Portland, USA; National Center for Rehabilitative Auditory Research (NCRAR), VA Portland Health Care System, Portland, USA., Brumbach BH; Biostatistics & Design Program, Oregon Health & Science University, Portland, USA., Pettigrew NC; Department of Neurology, Balance Disorders Laboratory, Oregon Health & Science University, Portland, USA; National Center for Rehabilitative Auditory Research (NCRAR), VA Portland Health Care System, Portland, USA; Department of Neurology, Center for Regenerative Medicine, Oregon Health & Science University, Portland, USA., Neilson A; Department of Neurology, Balance Disorders Laboratory, Oregon Health & Science University, Portland, USA., Parrington L; Department of Neurology, Balance Disorders Laboratory, Oregon Health & Science University, Portland, USA; Department of Dietetics, Human Nutrition and Sport, School of Sport and Exercise Science, La Trobe University, Melbourne, Australia., King LA; Department of Neurology, Balance Disorders Laboratory, Oregon Health & Science University, Portland, USA; National Center for Rehabilitative Auditory Research (NCRAR), VA Portland Health Care System, Portland, USA.
Jazyk: angličtina
Zdroj: Gait & posture [Gait Posture] 2023 Feb; Vol. 100, pp. 107-113. Date of Electronic Publication: 2022 Dec 07.
DOI: 10.1016/j.gaitpost.2022.12.005
Abstrakt: Purpose: Measuring persistent imbalance after mTBI is challenging and may include subjective symptom-reporting as well as clinical scales. Clinical assessments for quantifying balance following mTBI have focused on sensory orientation. It is theorized that balance control goes beyond sensory orientation and also includes subdomains of anticipatory postural adjustments, reactive postural control, and dynamic gait. The Mini Balance Evaluation Systems Test (Mini-BESTest) is a validated balance test that measures balance according to these subdomains for a more comprehensive assessment. The purpose of this study was to compare Mini-BESTest total and subdomain scores after subacute mTBI with healthy controls.
Methods: Symptomatic mTBI (n = 90, 20 % male, age=36.0 ± 12.0, 46.3.4 ± 22.1 days since injury) and healthy control (n = 45, 20 % male, age=35.4 ± 12.5) participants completed the Mini-BESTest for balance. Mini-BESTest between-group differences were evaluated using Wilcoxon rank-sum tests.
Results: The mTBI group (Median[minimum,maximum]) had a significantly worse Mini-BESTest total score than the healthy controls (24[18,28] vs 27[23-28], p < 0.001). The mTBI group performed significantly worse in 3 of the 4 subdomains compared to the healthy controls: reactive postural control: 5[2-6] vs 6[3-6], p = 0.003; sensory orientation: 6[5,6] vs 6[6], p = 0.005; dynamic gait: 8[5-10] vs 9[8-10], p < 0.001. There was no significance difference between groups in the anticipatory postural adjustments domain (5[3-6] vs 5[3-6], p = 0.12).
Conclusions: The Mini-BESTest identified deficits in people with subacute mTBI in the total score and 3 out of 4 subdomains, suggesting it may be helpful to use in the clinic to identify balance subdomain deficits in the subacute mTBI population. In combination with self-reported assessments, the mini-BESTest may identify balance domain deficits in the subacute mTBI population and help guide treatment for this population.
Competing Interests: Conflict of interest The authors have no conflicts of interest to disclose.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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