Analyses of gait, reaching, and grasping in children after traumatic brain injury.

OBJECTIVE To evaluate motor behavior in children after traumatic brain injury (TBI) with quantitative instrumented measures of gait and of functional hand movements (reaching, grasping) and with clinical assessments. DESIGN Case-control study. SETTING Tertiary pediatric trauma rehabilitation center in Germany. PARTICIPANTS Twenty children (age range, 6-13 y) with moderate or severe TBI were examined 1+/-1.2 years (mean +/- standard deviation) postinjury. Fifteen were reexamined 2 months later. Control data were obtained from 20 healthy children and matched for age, gender, and school grade. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Quantitative measures included 10 spatiotemporal gait parameters and 6 variables describing reaching and grasping. Qualitative scores of gait and upper-limb movements were also obtained. RESULTS Gait velocity and step and stride lengths were significantly smaller in children after TBI than in control subjects (Mann-Whitney U test, P<.05). Reach-to-grasp movements of the TBI children were characterized by a significantly longer reaction time (Mann-Whitney U test, P<.05) and movement duration, reduced velocity, and coordination deficits. The instrumented measures did not change significantly in 2 months. Several significant correlations between clinical and instrumented measures were obtained. CONCLUSION Functional motor behavior is affected in children after moderate or severe TBI. To supplement clinical assessments with objective data, impairments of gait, reaching, and grasping movements can be recorded with instrumented measures.