Sitting balance following brain injury: does it predict outcome?

Balance dysfunction is commonly observed following traumatic brain injury. There are many proposed predictors of functional outcome in the traumatic b rain injury population. It was hypothesized that the degree of balance dysf unction on admission to rehabilitation would be a significant predictor of the need for assistance at discharge, as measured by the Functional Indepen dence Measure (FIM). This study involved 237 cases of traumatic brain injur y patients admitted to a rehabilitation unit between November 1989 and Sept ember 1996. Using a multiple regression model, controlling for age, initial Glasgow Coma Score (GCS), rehabilitation admission strength, sitting balan ce and standing balance, it was found that the degree of impairment in sitt ing balance at admission to rehabilitation was a significant predictor of D ischarge FIM-Total (FIM-T) score (p < 0.0001) and also of selected elements from the Discharge FIM-Motor (FIM-M) score (p < 0.0005). The combination o f age, initial admission GCS, rehabilitation admission strength, standing b alance and sitting balance accounted for 29% of the variance in the Dischar ge Total FIM score. Among these, sitting balance was the second most powerf ul predictor of both selected elements of the Discharge FIM motor score and discharge FIM-T. Sitting balance predictive capacity was exceeded in power only by age. Impairments in sitting balance appear to have a significant i mpact on functional outcome. Emphasis on unique rehabilitation techniques t o treat balance dysfunction in the adult TBI population is warranted.