Severity and distribution of spasticity does not limit mobility or influence compensatory strategies following traumatic brain injury

Abstract

Primary objectives: To determine whether the severity of lower limb spasticity had a differential effect on mobility following traumatic brain injury (TBI) and to investigate whether the distribution of lower limb spasticity influenced compensation strategies when walking.

Research design: Ninety-three people attending physiotherapy for mobility limitations following TBI participated in this study. Participants were grouped according to the presence and distribution of lower limb spasticity for comparison.

Main outcomes and results: Mobility was measured using a 10-metre walk test and the high level mobility assessment tool. Three dimensional gait analysis was used to measure power generation and spasticity was assessed using the Tardieu scale. No significant relationship was found between the severity of lower limb spasticity and mobility limitations. There was a strong relationship between ankle power generation and mobility performance. Proximal compensation strategies did not vary significantly between groups with different distributions of lower limb spasticity.

Conclusion: The ability to generate ankle power has a large impact on mobility outcome following TBI. Although spasticity was prevalent, the severity and distribution did not appear to impact mobility outcomes. Proximal compensation strategies were not influenced by the distribution of lower limb spasticity following TBI.

Keywords: Brain injuries; gait; mobility limitation; muscle spasticity; muscle strength; running; walking.