Traumatic brain injury (TBI) is a leading cause of disability in the United States (Coronado et al., 2011). There is a recognized need for better motor assessments to help mitigate these disabilities. Advances in markerless motion capture and in magnetic resonance imaging (MRI) provide an opportunity to improve clinical assessments, and link them to damage measured in MRI scans. The primary aims of this research were to 1) develop a quantitative motor assessment (QMA), and seed a normative database to enable comparison of impaired behavior to unimpaired, 2) test the sensitivity of the QMA, and 3) link QMA results to underlying TBI damage.The QMA developed in Aim 1 consisted of five tests: finger oscillation, tremor, visually guided movement, reaction time, and balance. We administered the QMA and traditional analgous tests to 132 healthy 18-50 year olds. We later added a coginitive motor integration (CMI) test and a stength-dexterity pinch test, then administered them to 31 (16 male, mean age = 24.7) healthy individuals. We seeded a normative database for the QMA and CMI measures. (A normative database for the pinch test already exists.) Correlations between the QMA and traditional tests were weak but the QMA results followed expected trends.In the second aim, 31 (16 male, mean age = 24.7 years) individuals with TBI completed all of the motor tests, and age- and gender-matched controls completed the CMI and pinch tests. We tested the sensivity of the QMA, the CMI and pinch tests, and traditional tests by their ability to correctly identify TBI subjects based solely on test results. The QMA was more sensitive than the other test groups. In Aim 3, we performed a stepwise regression to evaluate the relationship between motor deficits and brain injury, using motor test results and MRI images from the TBI and control groups. We found significant relationships between deficits in precision and increases in superior lateral ventricular volumes, deficits in pointing tasks and decreases in fractional anisotropy (FA) in the corticospinal tract, deficits in rhythmicity during finger oscillation and decreased FA in the thalamocortical tract. There were also relationships between each of the motor deficit measures and the FA values in the corpus callosum. This was the first step in showing that a quantitative motor assessment using markerless motion capture is feasible. The QMA is sensitive and can be linked to underlying brain damage. Though the QMA is not yet ready for clinical use, this research provides insights that will help address gaps in TBI rehabilitation.
| Identifer | oai:union.ndltd.org:BGMYU2/oai:scholarsarchive.byu.edu:etd-9582 |
| Date | 01 July 2019 |
| Creators | Johnson, Paula K |
| Publisher | BYU ScholarsArchive |
| Source Sets | Brigham Young University |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | Theses and Dissertations |
| Rights | http://lib.byu.edu/about/copyright/ |
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