Assessing Task-Dependent Neurophysiology During Virtual Reality Treadmill Training in Adults With Traumatic Brain Injury: A Functional Near-Infrared Spectroscopy Feasibility Study.

Abstract

Objective: Individuals with traumatic brain injury (TBI) often experience residual mobility deficits that can be improved with treadmill and virtual reality interventions. However, previous studies have not measured the underlying neurophysiology during these interventions nor assessed if acquiring such data is feasible in a TBI population. Thus, the primary purpose of this study was to assess the feasibility of using portable functional near-infrared spectroscopy (fNIRS) to measure neurophysiology during a treadmill task and a treadmill with virtual reality task.

Setting: Data were collected in an outpatient setting at Craig Hospital.

Participants: Eight individuals with chronic moderate to severe TBI were recruited. The primary eligibility criteria include age of 18 years or older, diagnosis of moderate to severe TBI that initially required inpatient rehabilitation at least 1 year prior and could walk at least 10 feet without support from more than 1 person.

Design: Cross-sectional feasibility study. Participants were assessed with fNIRS while completing a 12-minute treadmill task and a 12-minute treadmill with virtual reality task. Feasibility benchmarks were established a priori and included safety, acceptability, data acquisition and quality metrics.

Main measures: Pre-determined feasibility objectives served as the primary outcome of this study. Global brain activity as measured by FNIRS was acquired during treadmill training alone and treadmill training with virtual reality in early, middle, and late epochs.

Results: The fNIRS protocol used in this study was safe for all participants and acceptable to 87.5% of participants. FNIRS data acquisition and quality benchmarks were achieved for 87.5% participants. Exploratory fNIRS analyses revealed significantly greater global brain activity during the treadmill with virtual reality task compared to the treadmill task alone in late epochs. No adverse events occurred.

Conclusion: All feasibility benchmarks were achieved suggesting that this fNIRS protocol can be used in future, larger-scale studies.