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Volume 44 Number 7 2007
Pages 975 — 982


Abstract - Motor impairment after severe traumatic brain injury: A longitudinal multicenter study

William C. Walker, MD;* Treven C. Pickett, PsyD

Hunter Holmes McGuire Department of Veterans Affairs Medical Center, Richmond, VA; Defense and Veterans Brain Injury Center, Richmond, VA; Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA

Abstract — Neuromotor impairment is a common sequela of severe traumatic brain injury (TBI) but has been understudied relative to neurocognitive outcomes. This multicenter cohort study describes the longitudinal course of neurological examination-based motor abnormalities after severe TBI. Subjects were enrolled from the four lead Department of Veterans Affairs and Defense and Veterans Brain Injury Center sites. The study cohort consisted of 102 consecutive patients (active duty, veteran, or military dependent) with severe TBI who consented during acute rehabilitation for data collection and completed all follow-up evaluations. Paresis, ataxia, and postural instability measures showed a pattern of improvement over time, with the greatest improvement occurring between the inpatient (baseline) and 6-month follow-up assessments. Involuntary movement disorders were rare at all time points. Two years following acute rehabilitation, more than one-third of subjects continued to display a neuromotor abnormality on basic neurological examination. Persistence of tandem gait abnormality was particularly common.

Key words: ataxia, brain injury, closed head injury, dyskinesias, measurement, neurological examination, outcomes, paresis, postural balance, rehabilitation.


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