Gait Performance in People with Symptomatic, Chronic Mild Traumatic Brain Injury

Martini, Douglas N., Parrington, Lucy, Stuart, Sam, Fino, Peter C. and King, Laurie A. (2020) Gait Performance in People with Symptomatic, Chronic Mild Traumatic Brain Injury. Journal of Neurotrauma, 38 (2). pp. 218-224. ISSN 0897-7151

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Abstract

There is a dearth of knowledge about how symptom severity affects gait in the chronic (>3 months) mild traumatic brain injury (mTBI) population despite up to 53% of people reporting persisting symptoms following mTBI. The purpose of this investigation was to determine if gait is affected in a symptomatic, chronic mTBI group and to assess the relationship between gait performance and symptom severity on the Neurobehavioral Symptom Inventory (NSI). Gait was assessed under single- and dual-task conditions using five inertial sensors in 57 control subjects and 65 people with chronic mTBI (1.1 year from mTBI). The single- and dual-task gait domains of Pace, Rhythm, Variability, and Turning were calculated from individual gait characteristics. Dual-task cost (DTC) was calculated for each domain. The mTBI group walked (domain z-score mean difference: single-task = 0.70; dual-task = 0.71) and turned (z-score mean difference: single-task = 0.69; dual-task = 0.70) slower (p<0.001) under both gait conditions, with less rhythm under dual-task gait (z-score difference = 0.21, p=0.001). DTC was not different between groups. Higher NSI somatic sub-score was related to higher single- and dual-task gait variability as well as slower dual-task pace and turning (p<0.01). People with chronic mTBI and persistent symptoms exhibited altered gait, particularly under dual-task, and worse gait performance related to greater symptom severity. Future gait research in chronic mTBI should assess the possible underlying physiological mechanisms for persistent symptoms and gait deficits.

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