Joyce Julie M, Debert Chantel T, Chevignard Mathilde, Sorek Gilad, Katz-Leurer Michal, Gagnon Isabelle, Schneider Kathryn J
Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.
Front Neurol. 2022 Aug 3;13:906697. doi: 10.3389/fneur.2022.906697. eCollection 2022.
Left untreated, balance impairment following moderate-to-severe traumatic brain injury (TBI) can be highly debilitating and hinder activities of daily life. To detect impairments, clinicians need appropriate assessment tools. The objective of this study was to evaluate the feasibility and utility of a battery of clinical balance assessments in adults with moderate-to-severe TBI within 6-months of injury. Thirty-seven adults with TBI [Glasgow Coma Scale score ≤ 12 (33 M/4 F) age 18-50 years] participated in balance testing. Assessments included the Balance Error Scoring System (BESS), National Institutes of Health Standing Balance Test (NIH-SBT), Functional Gait Assessment (FGA), Advanced Functional Gait Assessment (FGA-A), Tandem Gait Test (TGT), Berg Balance Scale (BBS), and Walking While Talking Test (WWTT). We identified pronounced ceiling effects on the BBS and FGA, two widely used clinical balance assessments. The NIH-SBT, WWTT, and FGA used in conjunction with the FGA-A, offered versatility in their capacity to assess patients across the balance severity spectrum. This study provides evidence to support a stepwise approach to balance assessment that can be adapted to the broad range of balance ability found in moderate-to-severe TBI.
如果不进行治疗，中重度创伤性脑损伤（TBI）后的平衡障碍会使人极度虚弱，并妨碍日常生活活动。为了检测这些障碍，临床医生需要合适的评估工具。本研究的目的是评估一系列临床平衡评估方法在损伤后6个月内的中重度TBI成年患者中的可行性和实用性。37名TBI成年患者[格拉斯哥昏迷量表评分≤12（33名男性/4名女性），年龄18 - 50岁]参与了平衡测试。评估包括平衡误差评分系统（BESS）、美国国立卫生研究院站立平衡测试（NIH-SBT）、功能性步态评估（FGA）、高级功能性步态评估（FGA-A）、串联步态测试（TGT）、伯格平衡量表（BBS）和边说话边行走测试（WWTT）。我们发现，在两种广泛使用的临床平衡评估方法BBS和FGA上存在明显的天花板效应。NIH-SBT、WWTT以及与FGA-A联合使用的FGA，在评估不同平衡严重程度的患者时具有多样性。本研究为支持一种逐步进行平衡评估的方法提供了证据，该方法可适用于中重度TBI患者广泛的平衡能力范围。
