Authors: Ann Karas Reinthal¹; Linda Moeller Mansour²; Glenna Greenwald²

Source: Pediatric Rehabilitation, Volume 7, Number 1, January-March 2004 , pp. 37-49(13)

Publisher: Taylor and Francis Ltd

Abstract:

Purpose: This case study examined the effectiveness of a programme designed to improve anticipatory postural control in an adolescent over years 2 and 3 post-traumatic brain injury (TBI). It was hypothesized that her difficulty in walking and talking simultaneously was caused by excessive co-activation of extremity, trunk, and oral musculature during upright activities.

Methods: The participant was treated weekly by physical and speech therapy. Treatment focussed on improving anticipatory postural control during gross motor activities in conjunction with oral-motor function.

Results: Initially, the participant walked using a walker at a speed of 23 cm s^-1. Two years later, she could walk without a device at 53 cm s^-1. Initial laryngoscopic examination showed minimal movement of the velum or pharyngeal walls; full movement was present after treatment. The measure of intelligibility improved from no single word intelligible utterances to 85% intelligible utterances after 2 years.

Discussion: The results suggest that less compensatory rigidification of oral musculature was needed to maintain an upright position against gravity as postural control improved.

Conclusion: An adolescent 1-year post-TBI was followed as she underwent additional rehabilitation focussed on improving anticipatory postural control. The functional goal of simultaneously talking while walking was achieved through this intervention.

Keywords: Traumatic brain injury; postural control; co-contraction

Document Type: Research article

DOI: http://dx.doi.org/10.1080/13638490310001653151

Affiliations: 1: Motion Analysis Laboratory Department of Health Sciences Cleveland State University 2121 Euclid Ave. Cleveland OH 44115 USA 2: Cleveland Clinic Children's Hospital for Rehabilitation Cleveland OH USA

Publication date: 2004-01-01

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