Dynamic balance recovery in chronic acquired brain injury participants following a perturbation training

Dynamic balance recovery in chronic Acquired Brain Injury participants following a perturbation training

10.1101/2021.01.25.21250435 ◽

2021 ◽

Author(s):

Katherin Joubran ◽

Simona Bar-Haim ◽

Lior Shmuelof

Keyword(s):

Brain Injury ◽

Dynamic Balance ◽

Balance Training ◽

Acquired Brain Injury ◽

Gait Velocity ◽

Minimal Detectable Change ◽

Walk Test ◽

Perturbation Training ◽

The Brain ◽

10 Meter Walk Test

AbstractBackgroundAcquired Brain Injury (ABI) is defined as a damage to the brain that occurs after birth. Subjects post-ABI suffer from dynamic balance impairments that persist years after the injury.ObjectiveTo explore the effect of a perturbation method which is consisted of unexpected balance perturbations using Re-Step™ technology on the recovery of dynamic balance and gait velocity in chronic ABI participants.MethodsIn a clinical trial, 35 chronic ABI participants (stroke and traumatic brain injury) participated in 22 sessions of perturbation-training, twice a week for 3 months. Dynamic balance was assessed pre and post-training using Community Balance and Mobility Scale (CB&M). Gait velocity was also assessed in the stroke participants using the 10-meter walk test (10MWT).ResultsDynamic balance improved significantly post-training (p=0.001). This improvement was greater than the improvement that was observed in a sub-group that was tested twice before training (p=0.04). 16 participants (45.7%) out of 35 met or exceeded minimal detectable change (MDC) of the CB&M Scale. Self-paced velocity also improved significantly (p=0.02) but only 2 participants (9.5%) out of 21 exceeded the MDC of 10MWT post-stroke.ConclusionsUnexpected balance perturbation-training using Re-Step™ technology led to an improvement in dynamic balance and gait velocity in chronic ABI participants. The advantage of Re-Step™ technology training compared to conventional balance training should be further examined.

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Coordination of Dynamic Balance During Gait Training in People With Acquired Brain Injury

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2011.11.002 ◽

2012 ◽

Vol 93 (4) ◽

pp. 636-640 ◽

Cited By ~ 5

Author(s):

Ross Allan Clark ◽

Gavin Williams ◽

Natalie Fini ◽

Liz Moore ◽

Adam Leigh Bryant

Keyword(s):

Brain Injury ◽

Dynamic Balance ◽

Acquired Brain Injury ◽

Gait Training

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The Functional and Structural Neural Correlates of Dynamic Balance Impairment and Recovery in Persons with Acquired Brain Injury

10.21203/rs.3.rs-706951/v1 ◽

2021 ◽

Author(s):

Katherin Joubran ◽

Simona Bar-Haim ◽

Lior Shmuelof

Keyword(s):

Brain Injury ◽

Brain Volume ◽

Balance Control ◽

Dynamic Balance ◽

Chronic Phase ◽

Acquired Brain Injury ◽

Structural Mri ◽

Post Intervention ◽

Balance Impairment ◽

Rehabilitation Treatment

Abstract Dynamic balance depends on the interaction between multiple brain networks and is impaired following Acquired Brain Injury (ABI). This study aims to characterize the brain functional and structural correlates of ABI-induced dynamic balance impairment and recovery at the chronic-phase following a rehabilitation treatment. 31 participants participated in a novel rehabilitation treatment composed of 22 sessions of perturbation training. Dynamic balance was assessed using the Community Balance and Mobility scale (CB&M) and the 10-Meter Walking Test (10MWT). Brain function was assessed based on resting-state fMRI scans which were analysed using independent component analysis (ICA), and regions of interest analyses. Brain volume was assessed using structural MRI and compared to age-matched and elderly participants. ICA revealed a reduction in component-related activation within the sensorimotor and cerebellar networks post-intervention (p < 0.035). Improvement in CB&M scale was associated with a reduction in FC within the cerebellar network (p = 0.023) and with baseline FC within the cerebellar-putamen (p = 0.002) and cerebellar-thalamic networks (p = 0.026). Improvement in 10MWT was associated with baseline FC within the cerebellar-putamen (p = 0.012) and cerebellar-cortical networks (p = 0.017, p = 0.004, p < 0.001and p = 0.005). A global brain volume reduction was found in the ABI-group when compared to the age-matched controls (p < 0.001), which was negatively associated with ABI chronicity, but not associated with CB&M scale. Our results show that dynamic balance recovery is associated with FC changes within and between the cerebellar and sensorimotor networks that are consistent with the contribution of modularity to balance control and recovery. The diffused atrophy post-ABI indicates that ABI led to a degenerative process.

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Training-the-Trainer on Assistive Technology for Cognition (ATC): Current Practices

Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders ◽

10.1044/nnsld23.2.90 ◽

2013 ◽

Vol 23 (2) ◽

pp. 90-94 ◽

Cited By ~ 2

Author(s):

Laurie Ehlhardt Powell ◽

Tracey Wallace ◽

Michelle ranae Wild

Keyword(s):

Brain Injury ◽

Assistive Technology ◽

Acquired Brain Injury ◽

Online Training ◽

Evidence Based ◽

Train The Trainer ◽

Rehabilitation Professionals ◽

Remote Locations ◽

Training Package ◽

And Training

Research shows that if clinicians are to deliver effective, evidence-based assistive technology for cognition (ATC) services to clients with acquired brain injury (ABI), they first need opportunities to gain knowledge and experience with ATC assessment and training practices (O'Neil-Pirozzi, Kendrick, Goldstein, & Glenn, 2004). This article describes three examples of train the trainer materials and programs to address this need: (a) a toolkit for trainers to learn more about assessing and training ATC; (b) a comprehensive, trans-disciplinary program for training staff to provide ATC services in a metropolitan area; and (c) an overview of an on-site/online training package for rehabilitation professionals working with individuals with ABI in remote locations.

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