Gait Impairment in Traumatic Brain Injury: A Systematic Review

Dever, Tony, Powell, Dylan, Graham, Lisa, Mason, Rachel, Das, Julia, Marshall, Steven J., Vitorio, Rodrigo, Godfrey, Alan and Stuart, Sam (2022) Gait Impairment in Traumatic Brain Injury: A Systematic Review. Sensors, 22 (4). p. 1480. ISSN 1424-8220

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Introduction: Gait impairment occurs across the spectrum of traumatic brain injury (TBI); from mild (mTBI) to moderate (modTBI), to severe (sevTBI). Recent evidence suggests that objective gait assessment may be a surrogate marker for neurological impairment such as TBI. However, the most optimal method of objective gait assessment is still not well understood due to previous reliance on subjective assessment approaches. The purpose of this review was to examine objective assessment of gait impairments across the spectrum of TBI. Methods: PubMed, AMED, OVID and CINAHL databases were searched with a search strategy containing key search terms for TBI and gait. Original research articles reporting gait outcomes in adults with TBI (mTBI, modTBI, sevTBI) were included. Results: 156 citations were identified from the search, of these, 13 studies met the initial criteria and were included into the review. The findings from the reviewed studies suggest that gait is impaired in mTBI, modTBI and sevTBI (in acute and chronic stages), but methodological limitations were evident within all studies. Inertial measurement units were most used to assess gait, with single-task, dual-task and obstacle crossing conditions used. No studies examined gait across the full spectrum of TBI and all studies differed in their gait assessment protocols. Recommendations for future studies are provided. Conclusion: Gait was found to be impaired in TBI within the reviewed studies regardless of severity level (mTBI, modTBI, sevTBI), but methodological limitations of studies (transparency and reproducibility) limit clinical application. Further research is required to establish a standardised gait assessment procedure to fully determine gait impairment across the spectrum of TBI with comprehensive outcomes and consistent protocols.

Item Type: Article
Additional Information: Funding information: This work was supported by Northumbria University as part of a doctoral research development fund programme (D Powell) and by the Private Physiotherapy Education Foundation (PPEF – 368; PI: Stuart). Dr Stuart is supported by grants from the Parkinson’s Foundation (PDF-FBS-1898, PDF-CRA-2073).
Uncontrolled Keywords: gait, TBI, concussion, inertial-measurement-unit, wearables, biomechanics
Subjects: B100 Anatomy, Physiology and Pathology
B800 Medical Technology
C600 Sports Science
Department: Faculties > Engineering and Environment > Computer and Information Sciences
Faculties > Health and Life Sciences > Sport, Exercise and Rehabilitation
Depositing User: Rachel Branson
Date Deposited: 17 Feb 2022 10:59
Last Modified: 17 Feb 2022 11:00

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