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. 2011 Winter;63(1):58-64.
doi: 10.3138/ptc.2009-53. Epub 2011 Jan 20.

Tests of static balance do not predict mobility performance following traumatic brain injury

Gavin P Williams  1 , Meg E Morris
Affiliations

Tests of static balance do not predict mobility performance following traumatic brain injury

Gavin P Williams et al. Physiother Can. 2011 Winter.

Abstract
in English, French

Purpose: To investigate the extent to which different single-limb support (SLS) parameters predict mobility performance following traumatic brain injury (TBI).

Methods: Seventy-one people with mobility limitations following TBI were assessed for balance and mobility performance in a human movement laboratory. Participants performed a clinical test of static balance that involved balancing in SLS on each leg with eyes open and eyes closed. Mobility performance was measured by self-selected gait speed and performance on the High Level Mobility Scale (HiMAT). Dynamic stability during walking was measured by quantifying lateral centre of mass (COM) displacement, width of base of support, and proportion of double-support stance time.

Results: Total static balance scores were strongly correlated with HiMAT scores (r=0.57, p<0.001) and lateral COM displacement (r=-0.51, p<0.001). Despite these strong correlations, however, balance scores explained only 32% of the variance in advanced mobility skills (r(2)=0.32) and 26% of the variance in lateral COM displacement (r(2)=0.26).

Conclusions: Since mobility performance varied widely for people with similar levels of balance, SLS time was not able to predict dynamic stability during gait, self-selected gait speed, or advanced mobility skills in people with TBI.

Objectif : Étudier à quel point divers paramètres relatifs aux supports posturaux simples (SPS) peuvent influer de manière prévisible sur la mobilité à la suite d'une lésion cérébrale traumatique (LCT).

Méthode : Un échantillon de 71 personnes avec des limitations de mobilité résultant d'une LCT a été étudié ; on a évalué l'équilibre et la mobilité de chaque personne dans un laboratoire de motricité humaine. Les participants ont pris part à un test clinique de leur équilibre statique, pour lequel ils devaient se balancer d'une jambe à l'autre avec un SPS, les yeux ouverts, puis les yeux fermés. La mobilité des participants a été évaluée lors de la locomotion, suivant une vitesse et le rendement choisis par chacun, sur l'HiMAT (Level Mobility Scale). La stabilité dynamique au cours de la marche a été mesurée en quantifiant le déplacement latéral du centre de masse (CM), la largeur de la base d'appui et la proportion du temps passé en station debout avec double appui.

Résultats : Les pointages totaux d'équilibre statique étaient conformes aux pointages obtenus sur l'HiMAT (r=0,57, p<0,001) et pour le déplacement latéral du CM (r=−0,51, p<,001). Malgré ces fortes corrélations toutefois, les pointages touchant l'équilibre n'expliquaient que 32 % des variations des habiletés motrices avancées (r2=0,32) et 26 % des variations du déplacement latéral du CM (r2=0,26).

Conclusions : Puisque la mobilité varie grandement entre les gens ayant un même degré d'équilibre, le temps de SPS n'était pas en mesure d'influer sur la stabilité dynamique durant la locomotion, sur la vitesse de locomotion choisie ou sur les habiletés motrices avancées des personnes ayant subi une LCT.

Keywords: balance; gait; mobility; traumatic brain injury.

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Figures

Figure 1
Figure 1
Relationship between total balance scores and self-selected gait speed. The solid line represents the line of best fit; the horizontal dotted line represents the mean total balance score for TBI; the vertical dotted line represents the normal self-selected walking speed for young adults.
Figure 2
Figure 2
Relationship between total SLS scores and High-Level Mobility Assessment Tool scores. The solid line represents the line of best fit; the horizontal dotted line represents the mean total balance score for TBI.
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