Citation

Peters DM, Jain S, Liuzzo DM, Middleton A, Greene J, Blanck E, Sun S, Raman R, Fritz SL. Arch. Phys. Med. Rehabil. 2014; 95(8): 1454-1460.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.apmr.2014.04.006

PMID

24769069

Abstract

OBJECTIVE: To determine the feasibility and impact of different dosages of Intensive Mobility Training (IMT) on mobility, balance, and gait speed in individuals with chronic traumatic brain injury (TBI).

DESIGN: Prospective, single group design with 3-month follow-up. SETTING: University research lab PARTICIPANTS: A volunteer sample of 10 participants with chronic TBI (≥3 months post-TBI, able to ambulate 3.05 m with or without assistance); median age 35.4 (IQR: 23.5, 46) years, median time post-TBI 9.91 (IQR: 6.3, 14.2) years. Follow-up data was collected for all participants. INTERVENTIONS: Twenty days (5 days/week x 4 weeks),150 minutes/day of repetitive, task-specific training equally divided among 1) balance, 2) gait training, and 3) strength, coordination, and range. MAIN OUTCOME MEASURES: Pain and fatigue were recorded before and after each session to assess feasibility. Treatment outcomes were assessed before training (pre), after 10 sessions (interim), after 20 sessions (post), and 3 months follow-up and included the Berg Balance Scale and gait speed.

RESULTS: Participants averaged 150.1 (2.7) minutes/session. Median pre-session and post-session pain scores were 0/10 for 20 sessions; median pre-session fatigue scores ranged 0-2.5/10, post-session scores ranged 3-5.5/10. Four outcome measures demonstrated significant improvement pre-test to interim, with 7/10 participants exceeding the minimal detectable change (MDC) for fast walking speed. At post-test, two additional measures were significant, with more participants exceeding MDCs. Changes in fast walking speed and Timed Up and Go were significant at follow-up.

CONCLUSIONS: Limited fluctuations in pain and fatigue scores indicate feasibility of IMT in this population. Participants demonstrated improvements in walking speed, mobility, and balance post-intervention, and maintained gains in fast walking speed and mobility at three months.

Language: en