Feasibility of an Instrumented Gait Testing Protocol for Children after Mild Traumatic Brain Injury

Background/Purpose: Identifying impaired dynamic postural control after mild traumatic brain injury (mTBI) is crucial to prevent subsequent trauma and may help stratify for the risk of developing postconcussive symptoms. Instrumented gait analysis via inertial sensors offers an objective method to detect even minor alterations in postural control. In the wake of the recently updated Sport Concussion Assessment Tool—which includes gait and dual task gait testing—further studies are necessary to explore the feasibility and reliability of these methods in pediatric cohorts.

Methods: Thirty-seven participants aged 13.32 ± 3.31 participated in the study. Mean time since TBI was 5.35 ± 2.92 years. Instrumented gait analysis was performed via a validated smartphone application. Gait testing included three tasks: single motor task (SMT), single cognitive task (SCT), and dual task (DT). Participants performed SMT and DT, while the application recorded gait parameters: step length (SL), step cadence (StC), gait velocity (GV), and center of mass displacement (COMdis). DT costs were calculated for motor parameter results, as well as for cognitive testing. Feedback forms were handed at the end of testing.

Results: While there was no significant sex dependency, an age dependency could be found for SMT SL (p = 0.001) and GV (p = 0.001) as well as SCT (p = 0.003). Participants showed greater SL, SC, GV, and COMdis in DT than in single task testing (p = 0.001–0.043). A good to excellent degree of reliability was demonstrated for SL, SC, GV, and COMdis measurements in single and dual motor tasks (ICC: 0.837–0.971) (p < 0.001). More than 80% of participants stated that the testing procedure was explained very well and was very to somewhat easy to perform. 78% of participants enjoyed the assessment.

Conclusion: Point-of-care instrumented gait analysis is a feasible and reliable diagnostic tool and may complement the clinical assessment to assess for impairments in dynamic postural control in children and adolescents who sustained a mBTI.

Publication History

Article published online:
13 November 2023