Speeded motor training leads to fMRI changes during imagined hallway walking conditions in adults with traumatic brain injury

OBJECTIVE: Traumatic brain injury (TBI) often leads to persistent deficits in multiple functional domains. fMRI data were collected in an 8-week trial of rapid resisted elliptical training in ambulatory adults with chronic TBI to promote motor, cognitive and behavioral function and adaptive brain plasticity. PARTICIPANTS: Nine participants with chronic TBI and 9 uninjured adults were used for comparison of gait and fMRI data. MAIN MEASURES: Gait speed during treadmill walking down a virtual‑reality hallway with (cluttered) or without (uncluttered) distractions. Hallway videos at individualized speeds were displayed during fMRI while participants imagined walking through them before and after the intervention. We hypothesized that brain activation outcomes would differ between groups, conditions, and after training, and would relate to balance outcomes reported previously. RESULTS: Cluttered hallway conditions activated more brain regions than uncluttered ones. Uninjured adults initially had greater activation in the primary motor cortex and in regions involved in visuospatial processing and postural control. Post-intervention, those with TBI demonstrated increased activation, minimizing group differences, particularly in motor-related regions. Post-training, improvements in postural control related directly to increased cerebellar activation. CONCLUSIONS: Speed-focused motor training successfully induced brain plasticity related to improved balance in participants with chronic TBI, reinforcing the benefits of regular exercise in this population.