Decreased Movement Path Tortuosity Is Associated With Improved Functional Status in Patients With Traumatic Brain Injury.

The Journal of head trauma rehabilitation

PubMedID: 25931181

Kearns WD, Scott S, Fozard JL, Dillahunt-Aspillaga C, Jasiewicz JM. Decreased Movement Path Tortuosity Is Associated With Improved Functional Status in Patients With Traumatic Brain Injury. J Head Trauma Rehabil. 2015;.
OBJECTIVE
To determine if movement path tortuosity in everyday ambulation decreases in Veterans being treated in a residential setting for traumatic brain injury. Elevated path tortuosity is observed in assisted living facility residents with cognitive impairment and at risk for falls, and tortuosity may decrease over the course of cognitive rehabilitation received by the Veterans. If observed, decreased tortuosity may be linked to improved clinical outcomes.

DESIGN
Longitudinal observational study without random assignment.

SETTING
Veterans Affairs Medical Center inpatient residential polytrauma treatment facility.

PATIENTS
Twenty-two Veterans enrolled in a postacute predischarge residential polytrauma treatment facility.

INTERVENTIONS
None, observation-only.

MAIN OUTCOME MEASURE
Mayo-Portland Adaptability Index-4, and movement path tortuosity measured by Fractal Dimension (Fractal D). Fractal D was obtained continuously from an indoor movement tracking system primarily used to provide machine-generated prompts and reminders to facilitate activities of daily living. Patients were deemed "responders" (N = 10) if a significant linear decline in Fractal D occurred over the course of treatment, or nonresponders (N = 12) if no significant decline was observed.

RESULTS
Responders had lower discharge Mayo-Portland Adaptability Inventory scores (mean = 32.6, SD = 9.53) than non-responders (mean = 39.5, SD = 6.02) (F = 2.07, df = 20, P = .05). Responders and nonresponders did not differ on initial injury severity or other demographic measures.

CONCLUSIONS
Fractal D, a relatively simple measure of movement path tortuosity can be linked to functional recovery from traumatic brain injury.