Background: Traumatic brain injury (TBI) is the number one killer of young adults in the United States. For the patient with a traumatic brain injury, the primary objective of physical therapy is to facilitate functional, physical independence. When a patient is nonambulatory or dependent in ambulation, a body weight support system may enable him or her to engage in task-specific gait training. Researchers have demonstrated improvements in balance, motor recovery, walking speed, and endurance following supported treadmill ambulation training (STAT). These improvements are documented primarily in patients with diagnoses of stroke, cerebral palsy, and spinal cord injury. Little published research exists to demonstrate the efficacy of STAT in the rehabilitation of pediatric patients with traumatic brain injuries.
Purpose: The purpose of this study was to explore the efficacy of STAT in a pediatric subject recovering from a traumatic brain injury.
Methods: An ABA single subject design was used. One seventeen-year-old subject, with a traumatic brain injury, was assessed for changes in gait quality, endurance and functional mobility using the GAITRite (Clifton NJ) gait mat, The Six Minute Walk Test and the Walking, Running and Jumping (E) dimension of the GMFM. The STAT intervention was performed three times per week during the three week B phase. Data was analyzed using a two-standard deviation band method.
Results: The subject demonstrated statistically significant improvements in gait velocity, step-length and stride-length on the GAITRite (Clifton NJ) gait mat. She demonstrated statistically significant gains in walking endurance on the Six Minute Walk Test and improvements in gross motor function on the walking, running and jumping dimension (E) of the GMFM. The subject maintained her gains through the second baseline phase in nearly all of these areas.
Discussion and Conclusion: The results of this study support the hypothesis that supported treadmill ambulation training will facilitate positive changes in measures of gait quality, endurance and functional mobility with a pediatric patient following a traumatic brain injury