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The effect of variable gait modes on walking parameters among children post severe traumatic brain injury and typically developed controls.

UNLABELLED
The goal of the present study was to assess the effect of various walking modes on dynamic gait characteristics and to evaluate the possible differences in the adaptation reactions between children post severe traumatic brain injury (TBI) and typically developed (TD) controls.


METHODS
Thirteen children post severe TBI, mean of 3.5 years post trauma, independent walkers, with a walking velocity > 1.1 m/sec, and 15 TD controls participated in this study. Ages were 7-13 years. Gait speed, step time and length and step time and length variability were assessed by an electronic walkway. The children completed three cycles on the walkway for each of the following situations: comfortable walking, walking as fast as possible, as slow as possible and walking on a straight line.


RESULTS
Despite a similar walking performance while walking at a "regular" speed, children post severe TBI exhibit a significantly reduced range of walking speeds (73-154 cm/sec), about half, as compared to TD children (54-193 cm/sec) across the study assignments. In addition, while "walking on a straight line" children post TBI walk slower, with increased step variability as compared to their peers.


CONCLUSION
Children post severe traumatic brain injury may achieve independent walking at a comparable rate to typically developed controls; however their impairments will be exacerbated as the demands increase. Since a variety of walking speeds is crucial for independent daily living at any age and for children in particular, and since adequate balance is an inherent element of walking, these issues need repeated assessments and the children should receive appropriate treatment.