Vestibular Rehabilitation Improves Gait Quality and Activities of Daily Living in People with Severe Traumatic Brain Injury: A Randomized Clinical Trial

• Published in: Sensors (Basel, Switzerland) Vol. 22; no. 21; p. 8553
• Main Authors: Tramontano, Marco, Belluscio, Valeria, Bergamini, Elena, Allevi, Giulia, De Angelis, Sara, Verdecchia, Giorgia, Formisano, Rita, Vannozzi, Giuseppe, Buzzi, Maria Gabriella
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 06-11-2022; MDPI
• Subjects: Activities of Daily Living; Balance; biomechanics; Brain; Brain Injuries, Traumatic - rehabilitation; Clinical trials; Concussion; Fitness equipment; Gait; Humans; inertial sensors; Integrated approach; Intervention; Medical research; Medicine, Experimental; movement analysis; Neurological disorders; neurorehabilitation; Patients; Posture; Quality of life; Rehabilitation; Single-Blind Method; Smoothness; sTBI; Traumatic brain injury; Treatment Outcome; Walking; wearables; RCT; smoothness; balance; locomotion; inertial sensors; wearables; biomechanics; movement analysis; sTBI; neurorehabilitation
• ISSN: 1424-8220; 1424-8220
• DOI: 10.3390/s22218553

Neurorehabilitation research in patients with traumatic brain injury (TBI) showed how vestibular rehabilitation (VR) treatments positively affect concussion-related symptoms, but no studies have been carried out in patients with severe TBI (sTBI) during post-acute intensive neurorehabilitation. We aimed at testing this effect by combining sensor-based gait analysis and clinical scales assessment. We hypothesized that integrating VR in post-acute neurorehabilitation training might improve gait quality and activity of daily living (ADL) in sTBI patients. A two-arm, single-blind randomized controlled trial with 8 weeks of follow-up was performed including thirty sTBI inpatients that underwent an 8-week rehabilitation program including either a VR or a conventional program. Gait quality parameters were obtained using body-mounted magneto-inertial sensors during instrumented linear and curvilinear walking tests. A 4X2 mixed model ANOVA was used to investigate session−group interactions and main effects. Patients undergoing VR exhibited improvements in ADL, showing early improvements in clinical scores. Sensor-based assessment of curvilinear pathways highlighted significant VR-related improvements in gait smoothness over time (p < 0.05), whereas both treatments exhibited distinct improvements in gait quality. Integrating VR in conventional neurorehabilitation is a suitable strategy to improve gait smoothness and ADL in sTBI patients. Instrumented protocols are further promoted as an additional measure to quantify the efficacy of neurorehabilitation treatments.