Gait during community ambulation and laboratory-based walking in people with mild traumatic brain injury

Abstract

Background

Gait impairments are common in individuals with mild traumatic brain injury (mTBI), presenting in the acute phase and often persisting in subtle ways over time. Despite the prominence of laboratory gait evaluations, a comprehensive understanding of gait deficits post-mTBI necessitates the examination of various gait domains in real-world environments. Assessing gait during a community ambulation task (CAT) may capture real-world challenges and influence focused interventions or rehabilitation in individuals with mTBI.

Research Question

The aim of the study was to compare gait performance across independent gait domains in individuals with and without mTBI using wearable sensors during both the CAT and laboratory tasks (i.e., 1-minute walk test). Additionally, associations between the CAT and single- and dual-task walking were investigated.

Methods

In this cross-sectional study, 107 participants, including individuals with mTBI (n = 52) and healthy controls (n = 55), underwent gait assessments during the CAT and 1-minute walk tests (single- and dual-task) using wearable sensors. Four independent gait domains (i.e., gait variability, pace, rhythm, and turning), consisting of thirteen gait variables, were analyzed. Statistical methods included t-tests and partial correlations, adjusted for covariates.

Results

Individuals with mTBI exhibited gait deficits across multiple gait domains. Specifically, increased gait variability, decreased gait pace and turns post mTBI were seen in the CAT and 1-minute walk tests. Notably, the CAT task exhibited greater gait differences in terms of gait variability and pace compared to the laboratory tasks. Across gait domains, the CAT revealed greater number of correlated measures with dual-task walking compared to single-task walking.

Significance

The community ambulation walking task showed more abnormalities across gait domains compared to laboratory walking tests, highlighting the potential importance of incorporating real-life, community ambulatory tasks into post-mTBI evaluation of mobility.