Spectral analysis of centre of pressure identifies altered balance control in individuals with moderate-severe traumatic brain injury

Abstract

Purpose: To identify impairments and recovery of balance control after moderate-severe traumatic brain injury (TBI) through spectral analyses of static balance tasks and to characterise the contributions of each limb to balance control.

Methods: A retrospective analysis of longitudinal balance data from force platforms at 2, 5, and 12 months post-injury in 31 individuals with moderate to severe TBI was performed. Single-visit data from age-matched controls (n = 22) were collected for descriptive comparison. Net and individual limb centre of pressure measures and inter-limb centre of pressure coherence were calculated in low (≤0.4 Hz) and high (≥0.4 Hz) frequencies in the anteroposterior and mediolateral directions during standing with the eyes open and closed.

Results: Standing with the eyes closed increased net centre of pressure spectral power in low and high frequencies. Individuals with TBI demonstrated recovery in high frequencies in net centre of pressure in the mediolateral direction. Inter-limb coherence in the anteroposterior and mediolateral directions increased (recovered) over time in high frequencies. Weight-bearing asymmetry was visible in high frequencies in the anteroposterior and mediolateral directions.

Conclusions: Increased amplitude of low and high-frequency power suggests that individuals with TBI included in this study have impaired anticipatory and reactive balance mechanisms, which may be driven by weight-bearing asymmetries and which recover over time.

Implications for rehabilitation

• Anticipatory and reactive balance impairments after traumatic brain injury may place individuals at increased risk for falls.

• Analyses from postural sway in static balance tasks infer changes in anticipatory or reactive balance control after traumatic brain injury.

• Addressing weight-bearing asymmetries in rehabilitation interventions post-traumatic brain injury may improve between-limb coordination for anticipatory and reactive balance control.

Keywords:

• Traumatic brain injuries
• postural balance
• inter-limb coordination
• coherence
• frequency analysis

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Acknowledgements

The authors acknowledge the staff of the Balance, Mobility and & Falls Clinic at Toronto Rehabilitation Institute and the staff who collected the cognitive measures from the Recovery Study, both of which assisted in the data collection. Robin Green holds a Tier 2 Canada Research Chair in Traumatic Brain Injury and Cognitive Rehabilitation Neuroscience. The views expressed do not necessarily reflect those of the funders and the funders had no roles in the study design; in the collection, analysis or interpretation of data; in the writing of the report; or in the submission to submit the article for publication.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Equipment and space have been funded with grants from the Canada Foundation for Innovation, Ontario Innovation Trust, and the Ministry of Research and Innovation. Olinda Habib Perez was supported by the ONF-REPAR and Ontario Student Opportunity Trust Funds. The Toronto Rehab Traumatic Brain Injury Recovery Study was supported by CIHR (MOP - 86704).