Article

OBJECTIVE: To study the effects of sensory modality of simultaneous tasks during
walking with and without obstacles after moderate to severe traumatic brain
injury (TBI). DESIGN: Group comparison study. SETTING: Gait analysis laboratory
within a postacute rehabilitation facility. PARTICIPANTS: Volunteer sample
(N=18). Persons with moderate to severe TBI (n=11) (9 men, 3 women; age,
37.56+/-13.79 y) and a comparison group (n=7) of subjects without neurologic
problems matched on average for body mass index and age (4 men, 3 women; age,
39.19+/-17.35 y). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES:
Magnitudes and variability for walking speeds, foot clearance margins (ratio of
foot clearance distance to obstacle height), and response reaction times (both
direct and as a relative cost because of obstacle avoidance). RESULTS: The TBI
group had well-recovered walking speeds and a general ability to avoid obstacles.
However, these subjects did show lower trail limb toe clearances (P=.003) across
all conditions. Response reaction times to the Stroop tasks were longer in
general for the TBI group (P=.017), and this group showed significant increases
in response reaction times for the visual modality within the more challenging
obstacle avoidance task that was not observed for control subjects. A measure of
multitask costs related to differences in response reaction times between
obstructed and unobstructed trials also only showed increased attention costs for
the visual over the auditory stimuli for the TBI group (P=.002). CONCLUSIONS:
Mobility is a complex construct, and the present results provide preliminary
findings that, even after good locomotor recovery, subjects with moderate to
severe TBI show residual locomotor deficits in multitasking. Furthermore, our
results suggest that sensory modality is important, and greater multitask costs
occur during sensory competition (ie, visual interference).

Langue : ANGLAIS