Significant balance improvements can occur in individuals with chronic traumatic brain injury through the use of two types of home exercise programs

• Main Author: Hays, Kaitlin
• Format: Web Resource
• Language: English
• Published: Morressier 01.01.2017
• DOI: 10.26226/morressier.5c7e3e1d29d813000cb41a24

Literature suggests that following a traumatic brain injury (TBI), the period of significant recovery lasts up to two years post injury (1, 2). As part of a randomized controlled trial, individuals with chronic TBI were found to make significant positive changes in their balance following 12 weeks of participation in a home exercise program (HEP). Participants received a standard HEP or an HEP using an Xbox Kinect virtual reality system. The purpose of this case series is to evaluate specific changes in outcomes for an individual in each arm of the study. The average age of all participants (n=63) was 48.8, with an average age since injury of 8.4 years. Participant one was a 57 year old male injured 10 years prior to study enrollment. He received a virtual reality based HEP. Participant two was a 58 year old female injured 6 years prior to study enrollment. This participant received a standard HEP. Both individuals made significant progress on the BESTest, Community Balance and Mobility Scale (CB&M), and Sensory Organization Test (SOT) at the end of 12 weeks and reached the MCID for all assessments. The MCID of the CB&M for individuals with TBI is 7.6 points (3), the MCID of the BESTest for individuals with stroke is 7.81 points (4), and the MCID of the SOT for individuals with vestibular issues is 8 points (5). Average changes in scores from baseline to 12 weeks for all 63 participants was 7.8 points on the CB&M and 5.3 points on the BESTest. Participant one had a change of 26 points on the CB&M, 9 points on the BESTest, and 20 points on the SOT. Participant two had a change of 22 points on the CB&M, 21 points on the BESTest, and 10 points on the SOT. Overall, this information is very encouraging, as it indicates that following a chronic injury, individuals can still make significant improvements in their balance through the use of an in-home balance program. Some individuals may be more successful than others as indicated by these case examples. The reasons for these significant improvements compared to group means may be due to individual motivation or the time and ability to prioritize the exercise program. Both of these individuals lived alone and were not currently working, but both were within group averages for consistency of HEP performance, age, and time since injury. REFERENCES1.tCorrigan JD, Selassie AW, Orman JAL. The epidemiology of traumatic brain injury. The Journal of head trauma rehabilitation. 2010;25(2):72-80.2.tBasford JR, Chou L-S, Kaufman KR, Brey RH, Walker A, Malec JF, et al. An assessment of gait and balance deficits after traumatic brain injury. Archives of physical medicine and rehabilitation. 2003;84(3):343-9.3.tHowe J, Inness E, Venturini A, Williams J, Verrier M. The Community Balance and Mobility Scale-a balance measure for individuals with traumatic brain injury. Clinical Rehabilitation. 2006;20(10):885-95.4.tChinsongkram B, Chaikeeree N, Saengsirisuwan V, Viriyatharakij N, Horak FB, Boonsinsukh R. Reliability and Validity of the Balance Evaluation Systems Test (BESTest) in People With Subacute Stroke. Physical Therapy. 2014;94(11):1632-43.5.tWrisley DM, Stephens MJ, Mosley S, Wojnowski A, Duffy J, Burkard R. Learning effects of repetitive administrations of the sensory organization test in healthy young adults. Archives of physical medicine and rehabilitation. 2007;88(8):1049-54.