The Recovery of Running Ability in an Adolescent Male After Traumatic Brain Injury: A Case Study

Background and Purpose: The purpose of this case study was to document outcomes after a rehabilitation program in an adolescent male after traumatic brain injury. Three years after sustaining an injury in a skiing accident, a 17-year-old boy participated in a rehabilitation program with the goal of acquiring the ability to run one mile with his peers. On initial evaluation, the individual had significant left lower extremity weakness, impaired standing balance, limited endurance, and running limitations. He was able to run 10 m wearing a plastic ankle-foot orthosis on the left side but required supervision for safety. Methods: The intervention included strength training once weekly for 17 weeks, body weight-supported, treadmill-based locomotor training once weekly for 15 weeks followed by a combination of overground locomotor training and strengthening exercise once weekly for six weeks. Outcomes: After the intervention, muscle strength of the lower extremities increased and the individual was able to run one mile independently. The quality of his running improved, with better mechanics to absorb forces at impact during the absorption phase and increased lower extremity extension during the propulsion phase. Discussion: A rehabilitation program consisting of strengthening and locomotor training improved running speed, quality, and endurance in an adolescent male after traumatic brain injury. He was able to progress to a less restrictive carbon fiber brace as a result of gains in lower extremity strength. This change in ability allowed him to participate in physical education by running on a track and playing softball with his peers.