Exploring the utility of dynamic motor control to assess recovery following pediatric traumatic brain injury: A pilot study

BackgroundPediatric traumatic brain injury can lead to severe disability. Currently used standard clinical measures effectively capture secondary functional impairments, but do not measure neurologic impairment directly. ObjectiveEvaluate the feasibility of walking dynamic motor control (walk-DMC) assessments to more directly measure neurological impairment and recovery for individuals post-traumatic brain injury. MethodsThe trajectory of walk-DMC and standard clinical measures of balance, mobility, and function were assessed in a cohort of individuals post-traumatic brain injury. Measures were collected throughout participants inpatient rehabilitation stay and at short- and long-term follow-up assessments. ResultsFour pediatric participants with severe traumatic brain injury enrolled. All participants demonstrated substantial neurological impairment at enrollment. All clinical measures showed an initial deficit followed by recovery, with most returning to nondisabled ranges over the study period for all participants. In contrast, walk-DMC scores demonstrated an initial acute deficit and did not reach nondisabled ranges for two of the participants, indicating persistent neurologic impairment. ConclusionWalk-DMC shows promise in its ability to identify subtle ongoing neurologic impairment compared to traditionally used clinical assessments of balance, mobility, and function. Further work in a larger cohort of participants with traumatic brain injury will improve understanding of how walking dynamic motor control changes with injury severity and where such a measure can serve as a leading indicator of neurologic and functional recovery.