Research Reports - Dual-task training for balance and mobility in a person with severe traumatic brain injury

J Neurol Phys Ther. 2013 Jan 30

Fritz NE, Basso DM

BACKGROUND AND PURPOSE:: Attentional impairments following severe traumatic brain
injury (TBI) are common and can lead to decreased functional mobility and
balance, as well as deficits in previously automatic movements such as walking
and stair climbing. The purpose of this case study was to determine the
feasibility and potential value of incorporating a cognitive-motor dual-task
training program into physical therapy for a patient with a severe TBI. CASE
DESCRIPTION:: The patient was a 26-year-old woman who sustained a severe TBI
during a motor vehicle accident 46 days prior to physical therapy evaluation. On
the 8-level Rancho Los Amigos Cognitive Function Scale, her functioning was
classified as level IV. She had impairments in attention, functional mobility,
and balance, all of which limited her ability to participate in activities of
daily living. INTERVENTION:: Physical therapy was provided over 26 days within
the inpatient rehabilitation setting. Interventions included mobility tasks such
as walking, balancing, and stair climbing. Mobility training was paired with
specific secondary cognitive and motor tasks. OUTCOMES:: Dual-task training may
have contributed to improvements on outcome measures designed to test divided
attention including the Walking While Talking Test and Trail Making Test and a
greater rate of improvement in walking speed and time to descend stairs when
compared to the baseline phase. DISCUSSION:: Addition of cognitive-motor
dual-task training to standard physical therapy in the inpatient rehabilitation
setting appears to be feasible and may have value for improving function in
individuals with severe TBI.

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