Dynamic balance recovery in chronic acquired brain injury participants following a perturbation training

Acquired brain injury (ABI) is defined as a damage to the brain that occurs after birth. Subjects post-ABI frequently suffer from dynamic balance impairments that persist years after the injury. This study aimed to investigate the effect of a perturbation method using mechatronic shoes that introduce unexpected balance perturbations on the recovery of dynamic balance and gait velocity in chronic ABI participants. In an intervention trial, 35 chronic ABI participants (stroke and traumatic brain injury) participated in 22 sessions of perturbation training, twice a week for 3 months. Dynamic balance was assessed pre- and post-training using Community Balance and Mobility Scale (CB&M). Gait velocity was also assessed in the stroke participants using the 10 Meter Walking Test (10MWT). Dynamic balance improved significantly post-training (P = 0.001). This improvement was greater than the improvement that was observed in a sub-group that was tested twice before training (P = 0.04). Sixteen participants (45.7%) out of 35 met or exceeded minimal detectable change (MDC) of the CB&M Scale. Self-paced velocity also improved significantly (P = 0.02) but only two participants (9.5%) out of 21 exceeded the MDC of 10MWT post-stroke. Our results suggest that unexpected balance perturbation training using mechatronic shoes leads to an improvement in dynamic balance and gait velocity in chronic ABI participants. The advantage of perturbation training using mechatronic shoes with respect to conventional balance training should be further examined.