TY - JOUR
T1 - Assessment of balance in people with mild traumatic brain injury using a balance systems model approach
AU - Campbell, Kody R.
AU - Scanlan, Kathleen T.
AU - Wilhelm, Jennifer L.
AU - Brumbach, Barbara H.
AU - Pettigrew, Natalie C.
AU - Neilson, Akira
AU - Parrington, Lucy
AU - King, Laurie A.
N1 - Funding Information:
This research was supported by the Assistant Secretary of Defense for Health Affairs under Award Number ( W81XWH-17-1-0424 ). The interpretations and conclusions of the authors are not necessarily supported by the Department of Defense.
Funding Information:
This research was supported by the Assistant Secretary of Defense for Health Affairs under Award Number (W81XWH-17-1-0424). The interpretations and conclusions of the authors are not necessarily supported by the Department of Defense.
Publisher Copyright:
© 2022 Elsevier B.V.
PY - 2023/2
Y1 - 2023/2
N2 - 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.
AB - 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.
KW - Balance systems
KW - Concussion
KW - Gait
KW - Mild traumatic brain injury
KW - Postural control
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U2 - 10.1016/j.gaitpost.2022.12.005
DO - 10.1016/j.gaitpost.2022.12.005
M3 - Article
C2 - 36516644
AN - SCOPUS:85145316284
SN - 0966-6362
VL - 100
SP - 107
EP - 113
JO - Gait and Posture
JF - Gait and Posture
ER -