Department of Neurology, Oregon Health and Science University, Portland, OR, USA; Veterans Affairs Portland Health Care System, Portland, OR, USA; Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK.
Department of Neurology, Oregon Health and Science University, Portland, OR, USA; Veterans Affairs Portland Health Care System, Portland, OR, USA.
Hum Mov Sci. 2020 Feb;69:102557. doi: 10.1016/j.humov.2019.102557. Epub 2019 Nov 26.
Mild traumatic brain injury (mTBI) can impact gait, with deficits linked to underlying neural disturbances in cognitive, motor and sensory systems. Gait is complex as it is comprised of multiple characteristics that are sensitive to underlying neural deficits. However, there is currently no clear framework to guide selection of gait characteristics in mTBI. This study developed a model of gait in chronic mTBI and replicated this in a separate group of controls, to provide a comprehensive and structured methodology on which to base gait assessment and analysis.
Fifty-two people with chronic mTBI and 59 controls completed a controlled laboratory gait assessment; walking for two minutes back and forth over a 13 m distance while wearing five wirelessly synchronized inertial sensors. Thirteen gait characteristics derived from the inertial sensors were selected for entry into the principle component analysis based on previous literature, robustness and novelty. Principle component analysis was then used to derive domains (components) of gait.
Four gait domains were derived for our chronic mTBI group (variability, rhythm, pace and turning) and this was replicated in a separate control cohort. Domains totaled 80.8% and 77.4% of variance in gait for chronic mTBI and controls, respectively. Gait characteristic loading was unambiguous for all features, with the exception of gait speed in controls that loaded on pace and rhythm domains.
This study contributes a four component model of gait in chronic mTBI and controls that can be used to comprehensively assess and analyze gait and underlying mechanisms involved in impairment, or examine the influence of interventions.
轻度创伤性脑损伤（mTBI）会影响步态，与认知、运动和感觉系统中潜在的神经紊乱有关的缺陷。步态很复杂，因为它由多个特征组成，这些特征对潜在的神经缺陷很敏感。然而，目前没有明确的框架来指导 mTBI 中步态特征的选择。本研究建立了慢性 mTBI 步态模型，并在另一组对照组中复制了该模型，为步态评估和分析提供了一个全面和结构化的方法。
52 名慢性 mTBI 患者和 59 名对照组在受控实验室步态评估中完成了测试；在佩戴五个无线同步惯性传感器的情况下，在 13 米的距离上来回走两分钟。根据先前的文献、稳健性和新颖性，从惯性传感器中选择了 13 个步态特征进入主成分分析。然后使用主成分分析得出步态的领域（成分）。
我们为慢性 mTBI 组得出了四个步态领域（变异性、节奏、步速和转弯），在一个单独的对照组中也得到了复制。领域分别占慢性 mTBI 和对照组步态的 80.8%和 77.4%。除了对照组的步态速度在节奏和步速领域加载外，所有特征的步态特征加载都是明确的。
本研究提出了一个慢性 mTBI 和对照组的四成分步态模型，可以用于全面评估和分析步态以及与损伤相关的潜在机制，或研究干预措施的影响。
