Department of Computer and Information Sciences, Northumbria University, Newcastle-upon-Tyne, UK.
Department of Neurology, Oregon Health and Science University, Portland, OR, USA.
J Neuroeng Rehabil. 2022 May 26;19(1):49. doi: 10.1186/s12984-022-01030-6.
Physical function remains a crucial component of mild traumatic brain injury (mTBI) assessment and recovery. Traditional approaches to assess mTBI lack sensitivity to detect subtle deficits post-injury, which can impact a patient's quality of life, daily function and can lead to chronic issues. Inertial measurement units (IMU) provide an opportunity for objective assessment of physical function and can be used in any environment. A single waist worn IMU has the potential to provide broad/macro quantity characteristics to estimate gait mobility, as well as more high-resolution micro spatial or temporal gait characteristics (herein, we refer to these as measures of quality). Our recent work showed that quantity measures of mobility were less sensitive than measures of turning quality when comparing the free-living physical function of chronic mTBI patients and healthy controls. However, no studies have examined whether measures of gait quality in free-living conditions can differentiate chronic mTBI patients and healthy controls. This study aimed to determine whether measures of free-living gait quality can differentiate chronic mTBI patients from controls.
Thirty-two patients with chronic self-reported balance symptoms after mTBI (age: 40.88 ± 11.78 years, median days post-injury: 440.68 days) and 23 healthy controls (age: 48.56 ± 22.56 years) were assessed for ~ 7 days using a single IMU at the waist on a belt. Free-living gait quality metrics were evaluated for chronic mTBI patients and controls using multi-variate analysis. Receiver operating characteristics (ROC) and Area Under the Curve (AUC) analysis were used to determine outcome sensitivity to chronic mTBI.
Free-living gait quality metrics were not different between chronic mTBI patients and controls (all p > 0.05) whilst controlling for age and sex. ROC and AUC analysis showed stride length (0.63) was the most sensitive measure for differentiating chronic mTBI patients from controls.
Our results show that gait quality metrics determined through a free-living assessment were not significantly different between chronic mTBI patients and controls. These results suggest that measures of free-living gait quality were not impaired in our chronic mTBI patients, and/or, that the metrics chosen were not sensitive enough to detect subtle impairments in our sample.
身体机能仍然是轻度创伤性脑损伤（mTBI）评估和康复的关键组成部分。传统的 mTBI 评估方法缺乏检测受伤后细微缺陷的敏感性，这会影响患者的生活质量、日常功能，并可能导致慢性问题。惯性测量单元（IMU）为身体机能的客观评估提供了机会，并且可以在任何环境中使用。单个佩戴在腰部的 IMU 具有提供广泛/宏观数量特征来估计步态活动能力的潜力，以及更精细的微观空间或时间步态特征（在此，我们将这些特征称为质量度量）。我们最近的工作表明，在比较慢性 mTBI 患者和健康对照组的自由生活身体机能时，移动性的数量度量不如转向质量度量敏感。然而，尚无研究检查自由生活条件下的步态质量测量是否可以区分慢性 mTBI 患者和健康对照组。本研究旨在确定自由生活步态质量测量是否可以区分慢性 mTBI 患者和对照组。
32 名慢性 mTBI 后（年龄：40.88 ± 11.78 岁，中位数伤后天数：440.68 天）且自我报告有平衡症状的患者和 23 名健康对照组（年龄：48.56 ± 22.56 岁）使用佩戴在腰带上的单个 IMU 进行了约 7 天的评估。使用多变量分析对慢性 mTBI 患者和对照组进行了自由生活步态质量指标的评估。使用接受者操作特征（ROC）和曲线下面积（AUC）分析来确定对慢性 mTBI 的敏感性。
在控制年龄和性别后，慢性 mTBI 患者和对照组的自由生活步态质量指标没有差异（均 P > 0.05）。ROC 和 AUC 分析显示，步长（0.63）是区分慢性 mTBI 患者和对照组最敏感的指标。
我们的结果表明，通过自由生活评估确定的步态质量指标在慢性 mTBI 患者和对照组之间没有显著差异。这些结果表明，在我们的慢性 mTBI 患者中，自由生活步态质量测量没有受损，或者我们选择的指标不够敏感，无法检测到我们样本中的细微损伤。
