Gait Performance in People with Symptomatic, Chronic Mild Traumatic Brain Injury.

There is a dearth of knowledge about how symptom severity affects gait in the chronic (>3 months) mild traumatic brain injury (mTBI) population despite up to 53% of people reporting persisting symptoms following mTBI. The purpose of this investigation was to determine if gait is affected in a symptomatic, chronic mTBI group and to assess the relationship between gait performance and symptom severity on the Neurobehavioral Symptom Inventory (NSI). Gait was assessed under single- and dual-task conditions using five inertial sensors in 57 control subjects and 65 people with chronic mTBI (1.1 year from mTBI). The single- and dual-task gait domains of Pace, Rhythm, Variability, and Turning were calculated from individual gait characteristics. Dual-task cost (DTC) was calculated for each domain. The mTBI group walked (domain z-score mean difference: single-task = 0.70; dual-task = 0.71) and turned (z-score mean difference: single-task = 0.69; dual-task = 0.70) slower (p<0.001) under both gait conditions, with less rhythm under dual-task gait (z-score difference = 0.21, p=0.001). DTC was not different between groups. Higher NSI somatic sub-score was related to higher single- and dual-task gait variability as well as slower dual-task pace and turning (p<0.01). People with chronic mTBI and persistent symptoms exhibited altered gait, particularly under dual-task, and worse gait performance related to greater symptom severity. Future gait research in chronic mTBI should assess the possible underlying physiological mechanisms for persistent symptoms and gait deficits.