Effects of Environmental Demands on Locomotion After Traumatic Brain Injury

Can measures of cognitive function predict locomotor behaviour in complex environments following a traumatic brain injury?

“…Parker et al [25] studied subjects who had sustained a concussion and healthy subjects and found that both groups had slower walking speed during dual task conditions as compared to single walking, but subjects with concussion were more affected. Recently published work by our group [1] has also shown that dual task behaviour is deficient in persons with moderate to severe TBI even with a high level of locomotor performance. In addition to decreases in the cognitive task performance (i.e., longer Stroop reading times), stride lengths and gait speed were reduced as compared to control subjects when complexity of the obstacle avoidance and secondary tasks increased.…”

“…In a recent study on environmental factors affecting TBI outcomes, Whiteneck, Gerhart and Cusick [12] found that people with TBI generally report environmental aspects such as lighting, noise and crowds to be physical barriers. When anticipatory locomotor adjustments are necessary for stepping over an obstacle, higher levels of caution predominate in high functioning people with TBI resulting in slower crossing speeds, shorter stride lengths and higher foot clearance margins [1,13]. Chou et al [14] also showed similar behaviour, discussed with respect to issues of imbalance.…”

Longitudinal assessment of gait abnormalities following penetrating ballistic-like brain injury in rats

“…Recovery of independent walking ability occurs on average by 1.5 months post-injury, with 94% of people recovering after 3 months (Katz et al, 2004). Vallee et al (2006) have showed that by 6 months post-injury TBI patients show walking speeds and stride lengths that are indistinguishable from healthy individuals during unobstructed walking. For comparison purposes, in which one adult rat day is equivalent to one human month (Quinn, 2005), recovery after PBBI directly paralleled the human recovery profile, where decreases in walking speed and stride length of PBBI rats were not significantly different from control by 7DPI (roughly 7 human months).…”

“…With time and rehabilitation, recovery of motor function in TBI patients is possible but varies, depending on personal and social factors (Vallee et al, 2006). In addition, lesion heterogeneity among patients makes it difficult to adopt generalizations regarding rates of recovery for the TBI population.…”

Bilateral claudication results in alterations in the gait biomechanics at the hip and ankle joints

“…Detailed quantitative evaluation of gait can be provided using advanced biomechanical analysis with joint kinetics and kinematics (Fosang and Baker, 2006;Winter, 2005). This analysis has been used extensively to characterize gait abnormalities of patients with cerebral palsy (Chang et al, 2006), stroke (McGinley et al, 2006;Yavuzer et al, 2006), head injury (Basford et al, 2003;Valle´e et al, 2006) and other neuromuscular disorders (Barker et al, 2006;Runge and Hunter, 2006). Furthermore, advanced biomechanical analysis has been used to guide rehabilitation and surgical treatment (Baker, 2006;Jo¨bges et al, 2004) and assess therapeutic outcomes Stergiou et al, 2007).…”