Nanette Aldahondo, Andrew J. Ries, Amy Schulz, Michael H. Schwartz
Abstract
Pediatric traumatic brain injury often leads to long-term disability. Unfortunately, while currently used standard clinical measures can effectively capture secondary functional impairments, they do not measure neurologic impairment directly.
Introduction
Traumatic brain injury (TBI) in children is a significant public health burden in the United States and can lead to severe disability. It has been estimated that more than 60% of children with moderate to severe TBI experience long-term disability [1], with the majority having complete or near-complete loss of walking ability in the acute period [2].
Materials and methods
This was an exploratory study with a convenience sample of children and adolescents (ages 4–18) admitted to an inpatient rehabilitation unit after sustaining a severe TBI. All study procedures were approved by the University of Minnesota Institutional Review Board (#00006147).
Results
Four participants with severe TBI were enrolled in this pilot study (Table 2). The principal investigator, study therapist, and study staff determined the more impaired side according to clinical measures of strength and motor control.
Discussion
This pilot study indicates that using only standard clinical assessments to monitor recovery from TBI may mask ongoing functional deficits, leading to a significant discrepancy between perceived and measured outcomes. These clinical measures are lagging indicators of recovery and do not capture the compensatory strategies a person may use to overcome continued neurologic impairment.
Conclusion
Pediatric TBI remains a significant public health burden in the United States and can lead to severe disability. Identifying a quantitative metric to measure impairment severity, track functional recovery, and potentially serve as a leading indicator to guide intervention is a key goal for improving treatment and enhancing recovery post-TBI.
Citation: Aldahondo N, Ries AJ, Schulz A, Schwartz MH (2026) Exploring the utility of dynamic motor control to assess recovery following pediatric traumatic brain injury: A pilot study. PLoS One 21(2): e0322674. https://doi.org/10.1371/journal.pone.0322674
Editor: Andrea Martinuzzi, IRCCS Medea: Istituto di Ricovero e Cura a Carattere Scientifico Eugenio Medea, ITALY
Received: March 26, 2025; Accepted: December 18, 2025; Published: February 4, 2026
Copyright: © 2026 Aldahondo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All relevant data are in the manuscript and supporting information files.
Funding: The author(s) received no specific funding for this work.
Competing interests: The authors have declared that no competing interests exist.
