Citation

Drijkoningen D, Caeyenberghs K, Vander Linden C, Van Herpe K, Duysens J, Swinnen SP. J. Neurotrauma 2015; 32(17): 1324-1332.

Affiliation

KU Leuven, Kinesiology, Leuven, Belgium ; David.Drijkoningen@faber.kuleuven.be.

Copyright

(Copyright © 2015, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2014.3787

PMID

25738975

Abstract

Traumatic brain injury (TBI) can lead to deficits in gait and posture which are often asymmetric. A possible factor mediating these deficits may be asymmetry in strength of the leg muscles. However, muscle strength in the lower extremities has rarely been investigated in (young) TBI patients. Here, we investigated associations between lower extremity muscle weakness, strength asymmetry and impairments in gait and posture in young TBI patients. A group of young patients with moderate to severe TBI (n=19, age 14y 11m ± 2y) and a group of typically developing subjects (n=31, age 14y 1m ± 3y) participated in this study. A force platform was used to measure postural sway to quantify balance control during normal standing and during conditions of compromised visual and/or somatosensory feedback. Spatiotemporal gait parameters were assessed during comfortable and fast-speed walking, using an electronic walkway. Muscle strength in 4 lower extremity muscle groups was measured bilaterally using a hand-held dynamometer.

FINDINGS revealed that TBI patients had poorer postural balance scores across all sensory conditions as compared to typically developing subjects. During comfortable and fast gait, TBI patients demonstrated a lower gait velocity, longer double support phase and increased step length asymmetry. Furthermore, the TBI patients had a reduced strength of the leg muscles and an increased strength asymmetry. Correlation analyses revealed that asymmetry in muscle strength was predictive of a poorer balance control and a more variable and asymmetric gait. To the best of our knowledge, this is the first study to measure strength asymmetry in the leg muscles of a sample of TBI patients and to illustrate the importance of muscular asymmetry as a potential marker and possible risk factor of impairments in the control of posture and gait.

Language: en