Assessment of postural instability in patients with traumatic brain injury upon enrolment in a vocational adjustment programme.

OBJECTIVE To assess postural instability in patients with traumatic brain injury upon enrolment to vocational adjustment. DESIGN A cross-sectional study. PATIENTS AND METHODS Sixty-eight patients at the time of admission to a vocational adjustment programme and 52 healthy age-matched controls were evaluated. Complaints of dizziness, or balance impairment and data from a clinical examination were recorded. Postural characteristics during quiet upright standing were assessed using a static posturographic platform. RESULTS Twenty-six patients complained of dizziness or instability and 36 had evidence of neurological impairment. Centre of pressure displacement and area were significantly increased in the traumatic brain injury group as a whole, compared with controls, even among 23 patients who had no complaint or clinical abnormality. CONCLUSION In spite of a high variability in time since injury, significant posturographic abnormalities were found in patients with traumatic brain injury, including those who had no complaints or evidence of neurological impairment. Posturography may help in understanding how a traumatic brain injury impairs the human balance, and may provide helpful information for patients participating in vocational adjustment programmes, especially when jobs require a long standing posture or balance.