Authors

  1. Ustinova, Ksenia I. PhD
  2. Silkwood-Sherer, Debbie J. PT, DHS

Abstract

Background and Purpose: Gripping a mobile (unfixed) object increases standing postural stability in healthy individuals. We tested whether the same strategy is effective for stabilizing upright posture perturbed by a moving environment (virtual perturbation) in participants with traumatic brain injury (TBI).

 

Methods: Fifteen participants with mild-to-moderate postural deficits after TBI and a comparison group of 15 age-matched healthy subjects participated in the study. Participants stood for 1 minute in front of a large screen with a projected three-dimensional image of a boat; for 30 seconds the boat remained stationary (no visual stimulation condition), and for 30 seconds the boat rocked on the water at a speed of 15[degrees]/s (visual stimulation condition). The visual stimulation was applied in pseudorandom order (during either the first or second half of the 1-minute trial). To analyze postural stability, the displacement and velocity of the center of mass in the sagittal and frontal planes were compared between groups and across 4 experimental conditions, including standing with/without visual stimulation and with/without gripping a 300-g object (short wooden stick) in the dominant hand.

 

Results: Participants with TBI showed greater instability under all experimental conditions. The visual stimulation significantly increased postural oscillations in the sagittal plane by 35% to 63% across groups. Gripping a stick significantly reduced the stimulation-induced instability in the sagittal plane by 19% to 29%, although not to the level of the no-stimulation condition in either group.

 

Conclusion: The stabilizing effect of gripping an external object in participants with TBI was confirmed. A possibility of using this effect as a balance aid strategy requires further investigation.

 

Audio Abstract available (see Audio, Supplemental Digital Content 1, http://links.lww.com/JNPT/A68 for more insights from the authors).