Use of an instrumented dual-task timed up and go test in children with traumatic brain injury.

BACKGROUND: Wearable sensors have allowed researchers to instrument tests of gait-related mobility, including the widely used timed 'up-and-go' test (TUG). Currently, there is a lack of instrumented test data on whether children with moderate to severe traumatic brain injury (TBI) perform differently on the TUG compared to typically developed (TD) controls during a cognitive-motor task. RESEARCH QUESTION: The aim was to explore the effects of a cognitive-motor task on TUG subcomponents among children with TBI compared to TD children. METHODS: This observational cross-sectional study included 12 children with moderate to severe TBI (6 males and 6 females, age 10.5 ±â€¯1.5 years of age) and 10 age and sex-matched TD controls (5 males and 5 females, 10.4 ±â€¯1.3 years of age). Each participant completed 6 trials of the TUG wearing a single inertial measurement unit sensor at a self-selected walking pace while listening to an array of 10 randomly presented single digits during each TUG trial. RESULTS: Total time to complete the TUG was not significantly different between groups. The cognitive-motor task led to significantly lower mean turn and peak turn angular velocity values during the turn-around-the-cone and turn-before-sitting TUG subcomponents in children with TBI compared to the TD controls (p ≤ 0.05). Additionally, the cognitive-motor task led to significantly lower values for maximum torso flexion to extension angle, peak flexion and extension angular velocity and peak vertical acceleration for the sit-to-stand subcomponent (p < 0.05). Peak flexion angular velocity during the stand-to-sit subcomponent was lower for the TBI group compared to the children with TD (p < 0.05). SIGNIFICANCE: The study provides new insights into the performance of complex gait-related mobility tasks in the context of an instrumented TUG among children with moderate to severe TBI. Our results highlight the potential benefits of outfitting pediatric inpatients with an IMU while completing the TUG.

Reliability of the sub-components of the instrumented timed up and go test in ambulatory children with traumatic brain injury and typically developed controls.

BACKGROUND: Studies have evaluated the test-re-test reliability of subcomponents of the timed up and-go test in adults by using body-worn inertial sensors. However, studies in children have not been reported in the literature. RESEARCH QUESTION: To evaluate the within-session reliability of subcomponents of a newly developed electronically augmented timed 'upand-go' test (EATUG) in ambulatory children with traumatic brain injury (TBI) and children with typical development (TD). METHOD: The timed up and go test was administered to twelve consecutive ambulatory children with moderate to severe TBI (6 males and 6 females, age 10.5 ±â€¯1.5 years, range 8-13 years, during inpatient rehabilitation at 27.0 ±â€¯11.8 days following injury) and 10 TD age and sex-matched children (5 males and 5 females, 10.4 ±â€¯1.3 years, range 8-11 years). Participants wore a single chest-mounted inertial measurement sensor package with custom software that measured angular and acceleration velocity and torso flexion and extension angles, while they performed 6 trials of the EATUG test. Measures were derived from the overall time to complete the TUG test, angular velocity and angular displacement data for torso flexion and extension during sit-to-stand and stand-to-sit segments and both mean and peak angular velocities for two turning segments (i.e. turning around a cone and turning-before-sitting). RESULTS: Within-session reliability of the subcomponents of the TUG test for children with TBI assessed by the intra-class correlation coefficient was ICC (1,1) = 0.84, (range 0.82-0.96), and for TD children ICC (1,1) = 0.73, (range 0.53-0.89). Scores on Total Time, maximum torso flexion/extension angle and peak flexion angular velocity during sit-tostand, and peak turn angular velocity for both turns around the cone and turns before sitting were lower for children with TBI than for TD children (p ≤ 0.05). SIGNIFICANCE: The EATUG test is a reliable measure of physical function in children with TBI who are being discharged from inpatient rehabilitation.