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Volume 90, Issue 4, Pages 587-593 (April 2009)


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Incidence of Gait Abnormalities After Traumatic Brain Injury

Presented in platform format to the International Brain Injury Association, Lisbon, Portugal, April 9-12, 2008.

Gavin Williams, PhDaCorresponding Author Informationemail address, Meg E. Morris, PhDb, Anthony Schache, PhDc, Paul R. McCrory, MDd

Abstract 

Williams G, Morris ME, Schache A, McCrory PR. Incidence of gait abnormalities after traumatic brain injury.

Objective

To identify the most common gait abnormalities presenting after traumatic brain injury (TBI) and quantify their incidence rate.

Design

Case series.

Setting

Biomechanics laboratory.

Participants

A convenience sample of 41 people with TBI receiving therapy for gait abnormalities, and a sample of 25 healthy controls.

Intervention

Three-dimensional gait analysis.

Main Outcome Measures

Spatiotemporal, kinematic, and kinetic data at a self-selected walking speed.

Results

People with TBI walked with a significantly slower speed than matched healthy controls. There was a significant difference between groups for cadence, step length, stance time on the affected leg, double support phase, and width of base of support. The most frequently observed biomechanical abnormality was excessive knee flexion at initial foot contact. Other significant gait abnormalities were increased trunk anterior/posterior amplitude of movement, increased anterior pelvic tilt, increased peak pelvic obliquity, reduced peak knee flexion at toe-off, and increased lateral center of mass displacement. Ankle equinovarus at foot-contact occurred infrequently.

Conclusions

People with TBI were found to have multijoint gait abnormalities. Many of these abnormalities have not been previously reported in this population.

a Epworth Hospital, Melbourne, and Centre for Health Exercise and Sports Medicine, School of Physiotherapy, The University of Melbourne, Melbourne, Australia

b School of Physiotherapy, The University of Melbourne, Melbourne, Australia

c School of Mechanical Engineering, The University of Melbourne, Melbourne, Australia

d Centre for Health Exercise and Sports Medicine, School of Physiotherapy, The University of Melbourne, Melbourne, Australia

Corresponding Author InformationCorrespondence to Gavin Williams, PhD, Physiotherapy Dept, Epworth Hospital, 89 Bridge Rd, Richmond, 3121, Victoria, Australia

 Supported by the Victorian Neurotrauma Initiative and Royal Automobile Club Victoria.

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

 Reprints are not available from the author.

PII: S0003-9993(08)01712-7

doi:10.1016/j.apmr.2008.10.013


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