Affiliations: [a] School of Physical and Occupational Therapy, McGill University, Montreal, PQ, Canada | [b] Montreal Children's Hospital, McGill University Health Center, Montreal, PQ, Canada
Correspondence:
[*]
Corresponding author: Isabelle. J. Gagnon, School of Physical and Occupational Therapy, McGill University, 3654, Promenade Sir William Osler, Montreal, QC, H3G1Y5, Canada. Tel.: +1 514 398 4400 ext. 099057; Fax: +1 514 398 8193; E-mail:isabelle.gagnon8@mcgill.ca
Abstract:
PURPOSE: To compare the ability of clinical balance measures to
detect differences between children recovered from a mild Traumatic Brain
Injury (mTBI) and healthy controls. METHODS: A cross-sectional study, with twenty-six children with
mTBI and twenty-two age-matched controls was conducted. Balance was
evaluated on three scales: Bruininks- Osteresky Test-second edition; Balance
Error Scoring System and Community Balance and Mobility Scale, along with
gait analysis of three paradigms (self-selected paced walking, obstacle
crossing and tandem walking), under single and dual-task conditions, using
GAITRite\scriptsize® walkway. Independent sample t-tests (α = 0.05)
were used to identify group differences. Dual-Task Cost (DTC) was analyzed
using repeated measures ANOVA and t-tests. Discriminant analysis predicted
which balance measure best identified the groups. RESULTS: Children with mTBI performed worse on all balance scales
(p< 0.05). Gait parameters were significantly better for the controls. There
were no group differences on the motor and cognitive DTC. The Community
Balance and Mobility Scale and gait parameters including velocity at
obstacle crossing and parameters for tandem walking, best discriminated the
groups. CONCLUSION: Clinical balance assessments may need to include static
and dynamic measures, to capture possible performance difficulties. The
inclusion of these measures will enhance clinical decision making and
prevent premature return to physical activities in children with mTBI.
Keywords: Balance, mobility or gait, children and adolescents, Mild Traumatic Brain Injury, concussion
