Motor impairment after severe traumatic brain injury: A longitudinal multicenter study

Abstract

Abstract-Neuromotor impairment is a common sequela of severe traumatic brain injury (TBI) but has been understudied relative to neurocognitive outcomes. This multicenter cohort study describes the longitudinal course of neurological examination-based motor abnormalities after severe TBI. Subjects were enrolled from the four lead Department of Veterans Affairs and Defense and Veterans Brain Injury Center sites. The study cohort consisted of 102 consecutive patients (active duty, veteran, or military dependent) with severe TBI who consented during acute rehabilitation for data collection and completed all follow-up evaluations. Paresis, ataxia, and postural instability measures showed a pattern of improvement over time, with the greatest improvement occurring between the inpatient (baseline) and 6-month follow-up assessments. Involuntary movement disorders were rare at all time points. Two years following acute rehabilitation, more than one-third of subjects continued to display a neuromotor abnormality on basic neurological examination. Persistence of tandem gait abnormality was particularly common.

Enhancing Rehabilitative Therapies with Vagus Nerve Stimulation

“…The effects of TBI are by nature heterogeneous, but moderate-to-severe TBIs can result in chronic deficits in motor function [77,78]. Recovery of motor function is associated with plasticity in spared motor circuits [79][80][81], and VNS paired with rehabilitation may enhance this plasticity to support recovery.…”

Virtual reality-based therapy for the treatment of balance deficits in patients receiving inpatient rehabilitation for traumatic brain injury

“…[6] Within the Physical domain, balance deficits are the one of the most common and physically limiting impairments resulting from TBI. [7,8] Balance can be described as the ability to maintain an upright position by keeping the body's center of gravity over its base of support as the body performs stationary or dynamic activity. [9,10] Previous research has suggested that upon admission to inpatient rehabilitation, almost 60% of patients with TBI will demonstrate impairment on the most basic of balance activities (sitting upright) and more than 75% will demonstrate impairment in slightly challenging balance activities (rising from sit to stand).…”

Investigating the Impact of Visual Biofeedback on Postural Control Via Informative Dynamic Balance Training in Healthy Individuals

“…Common cognitive impairments include reduced intellectual function, memory, processing speed, attention and language [1], whereas physical impairments include decreased balance, impaired proprioception, and dizziness [2,3]. These physical issues often impact the ability to ambulate and contribute to emotional impairments like depression.…”

“…Postural control is often affected due to disturbances in the vestibular system or to the motor cortex [2]. In a study by Geurts et al, static and dynamic postural control was compared in a TBI cohort against healthy controls [4,5].…”

“…In order to improve postural control, rehabilitation intervention is essential for recovery. In traditional rehabilitation, force platforms, weight measurement scales, and mirrors are often used to provide the patient with weight distribution biofeedback during stance [2,5,6]. With the incorporation of the biofeedback, the patient is able to visually determine if his or her weight is distributed asymmetrically and adjust accordingly.…”