Enhancing sensory acuity and balance function using near-sensory biofeedback-based perturbation intervention for individuals with traumatic brain injury

Article type: Research Article

Authors: Veerubhotla, Akhila^a | Pilkar, Rakesh^{b; *} | Ehrenberg, Naphtaly^c | Nolan, Karen J.^d

Affiliations: [a] Postdoctoral Fellow, Center for Mobility and Rehabilitation Engineering Research Kessler Foundation, West Orange, New Jersey, USA & Department of Physical Medicine and Rehabilitation, Rutgers –New Jersey Medical School, Newark, New Jersey, USA | [b] Research Scientist, Center for Mobility and Rehabilitation Engineering Research Kessler Foundation, West Orange, New Jersey, USA & Assistant Research Professor, Department of Physical Medicine and Rehabilitation, Rutgers –New Jersey Medical School, Newark, New Jersey, USA | [c] Biomedical Engineer Center for Mobility and Rehabilitation Engineering Research Kessler Foundation, West Orange, New Jersey, USA | [d] Senior Research Scientist, Center for Mobility and Rehabilitation Engineering Research Kessler Foundation, West Orange, New Jersey, USA & Associate Research Professor, Department of Physical Medicine and Rehabilitation, Rutgers –New Jersey Medical School, Newark, New Jersey, USA

Correspondence: [*] Address for correspondence: Rakesh Pilkar, Ph.D, Center for Mobility and Rehabilitation Engineering Research Kessler Foundation 1199 Pleasant Valley Way, West Orange, NJ 07052, USA. Tel.: +1 973 243 6838; Fax:+1 973 324 3527; E-mail: [email protected].

Abstract: BACGROUND:Interventions addressing balance dysfunction after traumatic brain injury (TBI) only target compensatory aspects and do not investigate perceptual mechanisms such as sensory acuity. OBJECTIVE:To evaluate the efficacy of a novel intervention that integrates sensory acuity with a perturbation-based approach for improving the perception and functional balance after TBI. METHODS:A two-group design was implemented to evaluate the effect of a novel, perturbation-based balance intervention. The intervention group (n = 5) performed the intervention with the sinusoidal (0.33, 0.5, and 1 Hz) perturbations to the base of support with amplitudes derived using our novel outcome of sensory acuity - perturbation perception threshold (PPT). The efficacy is evaluated using changes in PPT and functional outcomes (Berg Balance Scale (BBS), Timed-up and Go (TUG), 5-meter walk test (5MWT), and 10-meter walk test (10MWT)). RESULTS:There was a significant post-intervention change in PPT for 0.33 Hz (p = 0.021). Additionally, clinically and statistically significant improvements in TUG (p = 0.03), 5MWT (p = 0.05), and 10MWT (p = 0.04) were observed. CONCLUSIONS:This study provides preliminary efficacy of a novel, near-sensory balance intervention for individuals with TBI. The use of PPT is suggested for a comprehensive understanding and treatment of balance dysfunction. The promising results support the investigation in a larger cohort.

Keywords: Sensory threshold detection, perturbation-based intervention, biofeedback, sensory acuity, rehabilitation, traumatic brain injury

DOI: 10.3233/NRE-201502

Journal: NeuroRehabilitation, vol. Pre-press, no. Pre-press, pp. 1-9, 2020