DEFICITS IN ANKLE JOINT MECHANICS DURING RUNNING CAN BE RESOLVED WITH REHABILITATION IN PEOPLE WITH TRAUMATIC BRAIN INJURY

Williams G1,2, Schache A31Epworth Healthcare, Physiotherapy, Melbourne, Australia, 2The University of Melbourne, Physiotherapy, Melbourne, Australia, 3The University of Melbourne, Mechanical Engineering, Melbourne, AustraliaBackground: People with traumatic brain injury (TBI) have many high-level mobility goals, including running. However, running performance has received little attention in the neurological rehabilitation literature, yet many people with traumatic brain injury experience difficulty running. We recently demonstrated the first-ever evidence for the recovery of lower-limb power generation for walking, but recovery of lower-limb power generation for running is yet to be reported.Purpose: The aim of this study was to determine if a period of rehabilitation could also lead to the recovery of lower-limb power generation for running. Specifically the aims were 1) To compare lower-limb joint mechanics during running for people with traumatic brain injury (TBI) to equivalent data obtained from a group of healthy controls (HC); and 2) To determine if deficits identified in biomechanical variables during running for people with TBI were responsive to a six-month period of rehabilitation.Methods: Twelve ambulant people with extremely-severe TBI who were attending physiotherapy for mobility limitations, and a comparative sample of 10 HCs, underwent motion analysis. The main outcome measures were lower-limb (hip, knee and ankle) joint work and average power (i.e. over time) during stance. Outcome measures were compared between groups (i.e. TBI vs HC) as well as within group over time (i.e. TBI pre vs post rehabilitation).Results: Compared to HCs, participants with TBI at baseline ran with greater average power absorption at the hip (-0.27 W/kg vs -0.61 W/kg; p< 0.05), reduced average power absorption at the knee (-2.03 W/kg vs -1.02 W/kg; p< 0.05) and reduced average power generation at the ankle (2.86 W/kg vs 2.06 W/kg; p< 0.05). Only average power generation at the ankle improved following six months of rehabilitation for the participants with TBI (2.06 W/kg vs 2.79 W/kg; p< 0.05). No significant changes were observed in hip or knee joint mechanics.Conclusion(s): Recovery of running in people with TBI was mostly attributable to an improvement in ankle joint mechanics.Implications: This study presents the first ever evidence for the recovery of lower limb power generation for running. If specifically targeted, lower limb power generation for running may improve via a process of recovery rather than compensation.Keywords: Traumatic brain injury, running, biomechanicsFunding acknowledgements: The lead author was supported by a National Health and Medical Research Council fellowshipTopic: Neurology; Human movement analysis; Disability & rehabilitationEthics approval required: YesInstitution: Epworth HospitalEthics committee: Human Research & Ethics CommitteeEthics number: 34006All authors, affiliations and abstracts have been published as submitted.