An assessment of gait and balance deficits after traumatic brain injury

Arch Phys Med Rehabil. 2003 Mar;84(3):343-9. doi: 10.1053/apmr.2003.50034.


Objective: To assess the sensations of instability that many patients report after traumatic brain injury (TBI).

Design: A controlled study.

Setting: A motion analysis and vestibular and balance laboratory.

Participants: Twenty subjects, 10 with TBI and complaints of instability, and 10 without TBI.

Interventions: Balance and gait analysis.

Main outcome measures: Dizziness Handicap Inventory (DHI), caloric irrigation, optokinetic testing, Dix-Hallpike Test, posturography, and center of mass (COM) movement.

Results: Subjects were well matched in terms of age, height, weight, and gender. DHI scores of those with and without TBI differed significantly (32.2+/-23.0 vs 0.2+/-0.63, P<.001). Caloric and optokinetic circularvection testing were abnormal only in subjects with TBI (8/10 and 4/10, respectively). Benign paroxysmal positioning vertigo was present in only 3 subjects with TBI, and this either resolved spontaneously (n=1) or was successfully treated (n=2). Composite posturography scores of those with and without TBI differed significantly (69.6+/-35.8 vs 79.5+/-40.5, P=.02). Gait parameters also differed significantly between the groups (P=.05), with the subjects with TBI having lower anterior and posterior and higher medial and lateral COM displacements and velocities.

Conclusions: Patients' complaints of instability after TBI may have objective correlates and may be rectifiable. Balance and gait testing in these patients is warranted.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Auditory Threshold
  • Biomechanical Phenomena
  • Brain Injuries / complications
  • Brain Injuries / diagnosis*
  • Brain Injuries / physiopathology
  • Demography
  • Disability Evaluation
  • Dizziness / diagnosis
  • Dizziness / etiology
  • Female
  • Gait
  • Gait Disorders, Neurologic / diagnosis*
  • Gait Disorders, Neurologic / etiology
  • Gait Disorders, Neurologic / physiopathology
  • Glasgow Coma Scale
  • Glasgow Outcome Scale
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests / statistics & numerical data
  • Postural Balance*
  • Posture
  • Predictive Value of Tests
  • Sensation Disorders / diagnosis*
  • Sensation Disorders / etiology
  • Sensation Disorders / physiopathology
  • Vestibular Function Tests