| Summary: | 博士 === 國立陽明大學 === 醫學工程研究所 === 103 === Each year an estimated 2 million people in the United States sustain traumatic brain injury (TBI). Among all these mild traumatic brain injury (mTBI) approximately 75% of these injuries is mild in America. Approximately 82.2% of TBI are classified as mild TBI in Taipei city. The recovery is usually rapid after mTBI and most of patients are asymptomatic in three weeks, sometimes persist for several years following injury. Approximately, 10%–40% of patients continue to experience physical, cognitive and emotional symptoms and persistence of three symptoms with functional impairment for at least three months. We examined the disparities in balance functions and sensory integration between patients with mTBI within 1-week after injury and healthy controls. To further explore the evolution of balance and sensory integration of patients with mTBI for one year after injury. We recruited 107 patients with mTBI and 107 age- and sex-matched controls for this study. Symptoms of dizziness, balance functions, and the ability to perform daily activities were assessed using the dizziness handicap inventory (DHI). We also performed the postural-stability test and a modified clinical test of sensory integration by using the Biodex Stability System (BSS).
DHI scores (functional, emotional, physical, and total self-reported scores) were substantially increased in patients following an mTBI compared with the scores of the controls (p<.000). The postural stability test indices (anterior posterior) (p=.045) and the sensory-integration test index (eyes open firm surface index) (p=0.006) were substantially lower in patients with mTBI than in the controls. However, indices of 2 other postural-stability test indices (overall and medial lateral) and 3 other sensory integration tests indices (eyes closed firm surface, eyes open foam surface, and eyes closed foam surface) measured for the mTBI group did not differ from those of the control group. To further explore the evolution of balance and sensory integration of patients with mTBIs after injury of 1 year. We followed 25 patients with mTBIs and assessed DHI scores, postural-stability indices and sensory-integration indices. DHI score and postural-stability indices with mTBIs were substantially influenced with time course factor within 1 year. Furthermore, post-hoc revealed 4 scores and 3 indices were all improved than baseline through 6 month, but did not show further improvement at 1-year following injury. Sensory-integration indices were all not substantially influenced with time course factor within 1 year. Activities of daily living, balance in postural stability and sensory integration were impaired in patients with mTBI. Therefore, rehabilitation physicians and physical therapists in addition to the disposal of medical need, but also the need to address each aspect of the patient in order to prevent further injury, or further psychological trauma.
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