Changes in gait variability during different challenges to mobility in patients with traumatic brain injury

Abstract 

Postural stability may be compromised in patients who have sustained a traumatic brain injury (TBI). The purpose of the present study was to examine dynamic stability during gait by measuring spatial and temporal variability of foot placement, and to determine the effect of increased difficulty of the walking task on gait variability in patients with TBI. It was hypothesized that patients with TBI will show increased variability in step time, step length, and step width in comparison to healthy controls and that such differences would be accentuated by increased task difficulty. Participants (patients: n=20, controls: n=20) were asked to walk across a pressure sensitive mat at their preferred pace (PW), as fast as possible (FW), and with their eyes closed (EC). In accordance with the hypotheses, patients had significantly greater variability in step time and step length in comparison to healthy controls, and when the complexity of the gait task increased (FW and EC tasks). Although step width variability showed no significant difference between the groups, both control and patient groups had increased step width variability in the EC task. It is proposed that such increases in variability reflect greater challenges to maintaining dynamic stability during gait among individuals with TBI and when performing more difficult tasks.

Keywords: Traumatic brain injury, Gait, Variability, Dynamic stability