185. Engagement in a Visual Task Increases Postural Stability in Veterans with Mild Traumatic Brain Injury

Abstract: Background: Patients with mild traumatic brain injury (mTBI) often complain of balance problems. Balance is the ability to remain upright and steady with minimal postural sway, or horizontal movement of the center of gravity. Postural sway problems can indicate neurological dysfunction in sensory integration and motor coordination. Methods: Nineteen veterans with history of mTBI (mean age 49.5±11.4 years) and 26 controls (no TBI history; 49.6±12.1 years) were assessed. Participants stood with feet together on a Wii balance board for 60 seconds with eyes: 1) closed, 2) open, or 3) open, searching a paragraph of text attached to the wall for a particular letter (“search” task). Sway was quantified as the distance traveled per second in two directions: anterior-posterior (AP) and medial-lateral (ML). Results: A group (mTBI, control) x task (eyes closed, eyes open, search) mixed model ANOVA showed a significant interaction for sway in the AP direction. Post hoc pairwise t-tests revealed significantly decreased sway in the search task compared to the eyes open condition only in the mTBI group. For ML sway, there was a significant main effect of task (increased sway in the eyes closed task compared to the other tasks), but not group. Conclusions: Engagement in a visual task benefitted mTBI participants’ postural stability. This task engagement may add visual input to enhance integration of visual, vestibular, and proprioceptive information in mTBI to increase postural stability. Current findings suggest that objective assessment of postural sway may be an important tool in guiding rehabilitation of veterans with mTBI.