Physical Therapy Faculty Publications and Presentations

Document Type

Article

Publication Date

4-2023

Abstract

Background and Purpose:

The Functional Gait Assessment (FGA) and High Level Mobility Assessment Tool (HiMAT) are clinical batteries used to assess people with mild traumatic brain injury (mTBI). However, neither assessment was specifically developed for people with mTBI; the FGA was developed to evaluate vestibular deficits, and the HiMAT was developed for individuals with more severe TBI. To maximize the sensitivity and reduce the time burden of these assessments, the purpose of this study was to determine the combination of FGA and HiMAT items that best discriminates persons with persistent symptoms from mTBI from healthy controls.

Methods:

Fifty-three symptomatic civilians with persistent symptoms from mTBI (21% male, age 31(9.5) years, 328 (267) days since concussion and 57 healthy adults (28% male, age 32(9.6) years) participated across three sites. The FGA and HiMAT were evaluated sequentially as part of a larger study. To determine the best combination of items, a lasso-based generalized linear model (glm) was fit to all data.

Results:

The area under the curve (AUC) for FGA and HiMAT total scores were 0.68 and 0.66, respectively. Lasso regression selected four items including FGA Gait with Horizontal Head Turns and with Pivot Turn, and HiMAT Fast Forward and Backward Walk, and yielded an AUC (95% CI) of 0.71 (0.61, 0.79) using standard scoring.

Discussion and Conclusions:

The results provide initial evidence supporting a reduced, hybrid assessment of mobility (HAM-4-mTBI) for monitoring individuals with mTBI. Future work should validate the HAM-4-mTBI and investigate its utility for tracking progression throughout rehabilitation.

Publication Title

Journal of neurologic physical therapy : JNPT

DOI

https://doi.org/10.1097/NPT.0000000000000427

Download

Share

COinS