Article

Reduced balance, spasticity, contractures, muscle weakness, and motor
skill levels may all contribute to mobility limitations after traumatic brain
injury (TBI), yet the key physical impairments that contribute to mobility
limitations remain unclear. The aim of this study was to determine
which physical impairments best predict mobility performance after a period of 6
months of rehabilitation. PARTICIPANTS: Participants with TBI were selected if
they were receiving therapy for mobility limitations but were able to walk
without physical assistance. OUTCOME MEASURES: The clinical assessment included
measures of balance, spasticity, and contracture, and 3-dimensional quantitative
gait analysis was used to quantify joint power generation and motor skill level
on 31 adults with severe TBI. Mobility outcome was quantified with the high-level
mobility assessment tool. RESULTS: Two variables, ankle joint power generation
during the push-off phase of gait and motor skill level, explained 66.5% of the
variability in mobility outcome. Balance, strength, and mobility performance, all
improved significantly over the 6 months of rehabilitation. Only 2 participants
had contractures, which affected mobility. Balance disorders were prevalent and
improved with rehabilitation, yet they contributed to only a limited extent to
the level of recovery in mobility. CONCLUSION: Ankle joint power generation at
push-off was the strongest predictor of mobility outcome after 6 months of
rehabilitation in ambulant people with TBI.

Langue : ANGLAIS