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.
Document Type: Research article
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