Assessment and Rehabilitation of Central Sensory Impairments for Balance in mTBI
Abstract
Purpose and Background: Every year 1.5 million people get a traumatic brain injury (TBI) in the United States. Of these, 75% are considered mild traumatic brain injury (mTBI). While many people recover from a mTBI within 3 months, up to 40% develop "post-concussive syndrome," in which there is a very long or no recovery, with at least three or more symptoms. Balance complaints after mTBI are common and prevent people from returning to their previous quality of life. However, the reasons for long-lasting balance problems are not understood. We believe that the underlying problem results from damage to parts of the brain responsible for interpreting sensory information for balance control. Sensory integration depends upon the visual, vestibular (inner ear), and somatosensory (sensation from feet) information important for balance and can vary under different environmental conditions, such as on an unstable surface or in the darkness. The researchers in this project are experts at understanding and treating complex balance problems and have developed novel and portable ways to measure balance using new technology. The first aim of this study is to use novel techniques to assess and understand the root of balance problems after mTBI. The second aim is to test a novel audio biofeedback rehabilitation (ABF) approach in which patients hear through head phones how their body is moving so that can improve their walking and standing balance. Ultimate Use of the Research: People with long-lasting balance problems after mTBI will benefit from this project. Most people with mTBI who complain of feelings of unsteadiness, fogginess, and dizziness have not found a clinic that can measure their symptoms. If clinicians cannot measure the symptoms, it is difficult to treat. This difficultly measuring and treating the balance problems is frustrating for patients and their families and expensive for the healthcare system. Although our proposed studies are in people with long-lasting symptoms after mTBI, the findings could quite easily benefit rehabilitation of people soon after an mTBI. One goal of our study is to demonstrate how body-worn sensors could be useful to quickly evaluate balance problems that could affect fitness for duty. Our research team already uses this technology to test entire university sports teams, field-side, to establish normal values for these measures of balance. Potential Clinical Applications, Potential Risks, and Benefits: Chronic mTBI patients are very challenging and often have poor outcomes with traditional rehabilitation. Our proposed rehabilitation approach offers a new and simple way to test and improve their control of balance. The tools we propose here could easily be used by non-medical personnel to test balance recovery after concussion. The technology we propose in this project is becoming increasingly available and inexpensive. There are few potential risks to this study. These may include making symptoms worse during the testing and rehabilitation, emotional anxiety, and a slight fall risk. The potential benefits to subjects include insight into their balance problem, compensation for their participation, and rehabilitation for their deficit. An indirect benefit is that our study will provide information on what types of balance deficits are common after mTBI, which will help healthcare providers and patients not directly involved in the study. Timeline: We expect this project to take 4 years to complete. It will occur at two sites, Oregon Health & Science University and the Portland VA Medical Center. These institutions are located next to one another, connected by a sky bridge, and most team members work at both sites. Military Benefit: These proposed studies have the potential to change the way in which military personnel are assessed and rehabilitated after mTBI. When this project is completed, we expect to have shown that central sensory integration fo
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Apr 04, 2016
- Source ID
- W81XWH1510620
Entities
People
- Laurie A King
Organizations
- Oregon Health & Science University
- United States Army