Vestibular Rehabilitation Improves Gait Quality and Activities of Daily Living in People with Severe Traumatic Brain Injury: A Randomized Clinical Trial.

Abstract

Neurorehabilitation research in patients with traumatic brain injury (TBI) showed how vestibular rehabilitation (VR) treatments positively affect concussion-related symptoms, but no studies have been carried out in patients with severe TBI (sTBI) during post-acute intensive neurorehabilitation. We aimed at testing this effect by combining sensor-based gait analysis and clinical scales assessment. We hypothesized that integrating VR in post-acute neurorehabilitation training might improve gait quality and activity of daily living (ADL) in sTBI patients. A two-arm, single-blind randomized controlled trial with 8 weeks of follow-up was performed including thirty sTBI inpatients that underwent an 8-week rehabilitation program including either a VR or a conventional program. Gait quality parameters were obtained using body-mounted magneto-inertial sensors during instrumented linear and curvilinear walking tests. A 4X2 mixed model ANOVA was used to investigate session−group interactions and main effects. Patients undergoing VR exhibited improvements in ADL, showing early improvements in clinical scores. Sensor-based assessment of curvilinear pathways highlighted significant VR-related improvements in gait smoothness over time (p < 0.05), whereas both treatments exhibited distinct improvements in gait quality. Integrating VR in conventional neurorehabilitation is a suitable strategy to improve gait smoothness and ADL in sTBI patients. Instrumented protocols are further promoted as an additional measure to quantify the efficacy of neurorehabilitation treatments.

• Authors: Marco Tramontano, Valeria Belluscio, Elena Bergamini, Giulia Allevi, Sara De Angelis, Giorgia Verdecchia, Rita Formisano, Giuseppe Vannozzi, Maria Gabriella Buzzi
• Journal: Sensors (Basel, Switzerland) (Sensors (Basel)) Vol. 22 Issue 21 (Nov 06 2022) ISSN: 1424-8220 [Electronic] Switzerland
• PMID: 36366250 (Publication Type: Randomized Controlled Trial, Journal Article)

Topics

• Humans
• Activities of Daily Living
• Single-Blind Method
• Treatment Outcome
• Gait
• Brain Injuries, Traumatic (rehabilitation)