Title
Postural responses after utilization of a computerized biofeedback based intervention aimed at improving static and dynamic balance in traumatic brain injury: A case study
Abstract
Balance dysfunction is one of the most disabling aspects of Traumatic Brain Injury (TBI). Without rapid transmission and accurate perception of somatosensory inputs, the automatic postural responses required during standing may be delayed or absent after TBI which can lead to instability. Further, the sensitivity level to which environmental perturbations can be detected is also vital, as the central nervous system will only employ balance control strategies when it perceives a change in equilibrium. Such undetectable perturbations, however small they may be, can result in fatal falls, especially after TBI. In this investigation we used a novel computerized biofeedback based (CBB) intervention aimed at improving perception of external perturbations, and static and dynamic balance in a single male participant with severe TBI. We used an adaptive single interval adjustment matrix (SIAM) protocol to determine the perception of perturbation threshold (PPT) at baseline (1 day pre-intervention) and follow up (1 day post-intervention). External perturbations were provided through sinusoidal translations of 0.5 Hz to the base of support in anterior-posterior direction. Outcome measures included PPT, the Berg balance scale (BBS) and bilateral surface electromyography (EMG) of the lower limbs at baseline and follow up. PPT assessment post intervention showed a decrease in PPT, suggesting an improvement in the ability (gain of 0.42 mm) to detect (even smaller) perturbations which were not perceivable prior to the intervention. There was a significant increase in BBS (6 points) at follow up. The participant demonstrated increased muscle activation for the right gastrocnemius, left soleus, right bicep femoris and left vastus lateralis muscles at follow up. This investigation demonstrate the potential use of the CBB intervention for improving interpretation and organization of multisensory information in a task specific environment to improve balance dysfunction post TBI.
Year
DOI
Venue
2016
10.1109/EMBC.2016.7590631
2016 38th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC)
Keywords
Field
DocType
Accidental Falls,Biofeedback, Psychology,Brain Injuries, Traumatic,Brain-Computer Interfaces,Computers,Electromyography,Humans,Male,Muscle, Skeletal,Postural Balance,Posture
Dynamic balance,Electromyography,Psychology,Somatosensory system,Physical medicine and rehabilitation,Bicep femoris,Biofeedback,Perception,Traumatic brain injury,Berg Balance Scale
Conference
Volume
ISSN
ISBN
2016
1557-170X
978-1-4577-0219-8
Citations 
PageRank 
References 
0
0.34
0
Authors
5
Name
Order
Citations
PageRank
Rakesh B Pilkar101.01
Nibal Arzouni200.34
Arvind Ramanujam301.01
Kathleen Chervin400.34
Karen J. Nolan513.81