Individuals with chronic traumatic brain injury improve walking speed and mobility with intensive mobility training

Denise M. Peters, Sonia Jain, Derek M. Liuzzo, Addie Middleton, Jennifaye Greene, Erika Blanck, Shelly Sun, Rema Raman, Stacy L. Fritz

Research output: Contribution to journalArticle

5 Citations (Scopus)

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 laboratory. Participants Volunteer sample of participants with chronic TBI (N=10; ≥3mo post-TBI; able to ambulate 3.05m with or without assistance; median age, 35.4y; interquartile range, 23.5-46y; median time post-TBI, 9.91y; interquartile range, 6.3-14.2y). Follow-up data were collected for all participants. Interventions Twenty days (5d/wk for 4wk), with 150min/d of repetitive, task-specific training equally divided among balance; gait training; and 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 at 3-months follow-up and included the Berg Balance Scale and gait speed. Results Participants averaged 150.1±2.7 minutes per session. Median presession and postsession pain scores were 0 (out of 10) for 20 sessions; median presession fatigue scores ranged from 0 to 2.5 (out of 10); and postsession scores ranged from 3 to 5.5 (out of 10). Four outcome measures demonstrated significant improvement from the pretest to interim, with 7 out of 10 participants exceeding the minimal detectable change (MDC) for fast walking speed. At the posttest, 2 additional measures were significant, with more participants exceeding the MDCs. Changes in fast walking speed and Timed Up and Go test 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 postintervention and maintained gains in fast walking speed and mobility at 3 months.

Original languageEnglish (US)
Pages (from-to)1454-1460
Number of pages7
JournalArchives of Physical Medicine and Rehabilitation
Volume95
Issue number8
DOIs
StatePublished - 2014
Externally publishedYes

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Chronic Brain Injury
Fatigue
Pain
Outcome Assessment (Health Care)
Gait
Walking Speed
Traumatic Brain Injury
Volunteers
Research

Keywords

  • Brain injuries
  • Gait
  • Rehabilitation

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Individuals with chronic traumatic brain injury improve walking speed and mobility with intensive mobility training. / Peters, Denise M.; Jain, Sonia; Liuzzo, Derek M.; Middleton, Addie; Greene, Jennifaye; Blanck, Erika; Sun, Shelly; Raman, Rema; Fritz, Stacy L.

In: Archives of Physical Medicine and Rehabilitation, Vol. 95, No. 8, 2014, p. 1454-1460.

Research output: Contribution to journalArticle

Peters, DM, Jain, S, Liuzzo, DM, Middleton, A, Greene, J, Blanck, E, Sun, S, Raman, R & Fritz, SL 2014, 'Individuals with chronic traumatic brain injury improve walking speed and mobility with intensive mobility training', Archives of Physical Medicine and Rehabilitation, vol. 95, no. 8, pp. 1454-1460. https://doi.org/10.1016/j.apmr.2014.04.006
Peters, Denise M. ; Jain, Sonia ; Liuzzo, Derek M. ; Middleton, Addie ; Greene, Jennifaye ; Blanck, Erika ; Sun, Shelly ; Raman, Rema ; Fritz, Stacy L. / Individuals with chronic traumatic brain injury improve walking speed and mobility with intensive mobility training. In: Archives of Physical Medicine and Rehabilitation. 2014 ; Vol. 95, No. 8. pp. 1454-1460.
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AB - 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 laboratory. Participants Volunteer sample of participants with chronic TBI (N=10; ≥3mo post-TBI; able to ambulate 3.05m with or without assistance; median age, 35.4y; interquartile range, 23.5-46y; median time post-TBI, 9.91y; interquartile range, 6.3-14.2y). Follow-up data were collected for all participants. Interventions Twenty days (5d/wk for 4wk), with 150min/d of repetitive, task-specific training equally divided among balance; gait training; and 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 at 3-months follow-up and included the Berg Balance Scale and gait speed. Results Participants averaged 150.1±2.7 minutes per session. Median presession and postsession pain scores were 0 (out of 10) for 20 sessions; median presession fatigue scores ranged from 0 to 2.5 (out of 10); and postsession scores ranged from 3 to 5.5 (out of 10). Four outcome measures demonstrated significant improvement from the pretest to interim, with 7 out of 10 participants exceeding the minimal detectable change (MDC) for fast walking speed. At the posttest, 2 additional measures were significant, with more participants exceeding the MDCs. Changes in fast walking speed and Timed Up and Go test 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 postintervention and maintained gains in fast walking speed and mobility at 3 months.

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