OHSU research targets chronic balance dysfunction in mTBI patients

Abnormal balance control during standing and walking has been documented in patients who have sustained a mild traumatic brain injury (mTBI) or concussion. These problems may improve over the weeks following injury for many people, however, balance related impairments remain a common complaint in those suffering from the chronic effects of mTBI.

: Sway of patient before (black line) and after (blue line) rehabilitation
Sway of patient before (black line) and after (blue line) rehabilitation

Under the lead of Dr. Laurie King (PI), postdoctoral scholars Dr. Lucy Parrington and Dr. Peter Fino are seeking ways to better measure components of balance in the chronic mTBI population, and how this information can be translated into clinical practice for evaluation and rehabilitation.

Through the use of novel multi-modal testing procedures, Dr. King’s team has begun investigating balance and gait in patients with chronic balance dysfunction following mTBI.

Their preliminary findings have indicated that patients with chronic mTBI weight the information from sensorimotor, vestibular and visual systems in a different way when compared with healthy participants during postural assessments, and that they reorient their body in a different way when turning during mobility tasks.

In addition to investigating objective ways to quantify balance and gait in patients with chronic mTBI, members of Dr. King’s team are also evaluating the use of auditory biofeedback during rehabilitation.

: Example of one of the balance tests
One of the balance tests

The study aims to enroll patients with chronic mTBI, who have had balance related symptoms persisting greater than 3 months, into a 6-week targeted rehabilitative program.

The intervention uses novel tasks aimed at improving the interaction between somatosensory, visual and vestibular systems. To assess the effectiveness of the intervention, changes in balance measures and symptoms are compared to those collected on healthy people over the same timeline.

The research is in the early stages of investigation, but preliminary analyses are indicating promising improvements in patients following rehabilitation. However, the research team will have to wait until further patients have been evaluated to see whether auditory biofeedback enhances the recovery process.

The team working on this research also includes: Dr. Robert Peterka1, Ms Alexa Beeson2, Dr. James Chesnutt3, Dr. Timothy Huller4, Dr. Jenny Wilhelm5, Dr. Marco Jurado4, and Dr. Sean Kampel1.

This work was supported by the Assistant Secretary of Defense for Health Affairs under Award No.W81XWH-15-1-0620. Opinions, interpretations, conclusions and recommendations are those of the author and are not necessarily endorsed by the Department of Defense.

National Center for Rehabilitative Auditory Research, VA Portland Health Care System
Balance Disorders Laboratory, Neurology Department, OHSU
Orthopedics and Rehabilitation, School of Medicine, OHSU
Department of Otolaryngology, OHSU
Department of Rehabilitation Services, OHSU




Lucy Parrington, Ph.D. is a Postdoctoral Research Scholar in the Balance Disorders Laboratory at OHSU.