Computerized dynamic posturography detects balance deficits in individuals with a history of chronic severe traumatic brain injury

• Published in: Brain injury 2016-08, Vol.30 (10), p.1249-1255
• Main Authors: Buster, Thad W., Chernyavskiy, Pavel, Harms, Nolan R., Kaste, E. Grace, Burnfield, Judith M.
• Format: Article
• Language: English
• Subjects: Adult; assessment; Brain Injury, Chronic - complications; Diagnosis, Computer-Assisted - methods; disability; Female; Humans; Male; measurement; Middle Aged; Postural Balance - physiology; rehabilitation; Sensation Disorders - diagnosis; Sensation Disorders - etiology; Severity of Illness Index; Traumatic brain injury; Young Adult
• ISSN: 0269-9052; 1362-301X
• DOI: 10.1080/02699052.2016.1183822

Background: Mild balance deficits can be challenging to detect in individuals with long-standing traumatic brain injuries. This study compared Computerized Dynamic Posturography (CDP) scores from individuals with traumatic brain injuries (TBI) to controls to determine if CDP could differentiate between the two groups and determine if there was a learning effect associated with testing that could be used to guide evaluation of baseline balance. Methods: Ten ambulatory individuals with a history of severe TBI and 10 individuals without participated in three CDP sessions (24-72 hours apart). During each session, participants performed the Berg Balance Test, Dynamic Gait Index and three trials of a standardized balance assessment and Dynamic Movement Analysis (DMA) scores were recorded for each test. Results: Individuals with TBI scored 93% higher (i.e. reflecting poorer balance) than the control group. The group with TBI exhibited 6.6-times more variability compared to the control group, with estimated variances of 0.3407 and 0.0517, respectively. A learning effect was detected in the group with TBI on the first day of testing (β TBI F = -0.1241, p-value < 0.01). Discussion: The CDP system detected balance differences between individuals with TBI and controls. Given the documented learning effect, the best of three trials should be used to accurately assess baseline scores.