Book excerpt: BACKGROUND: Traumatic brain injury (TBI) is a serious health problem and a major cause for morbidity and mortality in the United States, which affects roughly 1.4-1.6 million Americans each year. Common impairments seen in those whom have suffered a TBI can include gait and balance disturbances and symptoms such as ataxia and bradykinesia. Body weight supported treadmill training (BWSTT) has been shown to have strong evidence for recovery of gait in populations such as Stroke, Parkinson’s, and Cerebral Palsy, however the consensus for the effectiveness of this intervention in TBI and ataxia is not as strong. PURPOSE: The purpose of this single subject research study examines the effectiveness of locomotor training on gait parameters, such as ataxia and bradykinesia, using body-weight support on a treadmill and over ground walking on a participant who is ambulatory without an assistive device in improving gait and daily functional abilities. CASE DESCRIPTION: SUBJECT: The participant, IG, a 26 year-old male suffered a severe traumatic brain injury and related multiple traumas secondary to a motor vehicle accident 4.5 years ago. He spent 1 week in intensive care being placed in an induced coma with a ventilator for 3 days, after which he was placed on 1 month bed rest, and subsequently admitted into inpatient rehabilitation where he received 4 months of interdisciplinary care. At the time of the study IG was walking independently, but presented with significant ataxia of arms, trunk, and legs, ataxic slurred speech, generalized bradykinesia of fine and gross movements, and impaired postural control with standing and gait. INTERVENTION: Our study followed an ABAB design with a baseline phase, 2 intervention phases, a data collection phase between the intervention phase, and a 1-month follow up visit. Each phase lasted 6 weeks and the patient was seen 1x/week during baseline and data collection, and 3x/week during intervention phases. The training sessions lasted 1 to 1 hour and 15 minutes and consisted of BWSTT on a treadmill and over ground, and over ground training. OUTCOMES: The participant demonstrated an improved outcome measure score for the SARA (baseline=11.67, 1st data collection=7.58, 1 month follow-up=8.5) and FGA (baseline=5.67, 1st data collection=8.83, 1 month follow-up=13), but did not see a change in walking velocity (baseline=.1312m/s, 1st data collection=.1144, 1 month follow-up=.1180). Following the intervention phases, the SARA and FGA scores fell outside of the two standard deviation bands while his walking velocity remained within the two standard deviation band. DISCUSSION: This study examined the effects on the parameters of gait, including ataxia and bradykinesia following locomotor training using BWSTT in conjunction with BWSTT over ground and over ground training without any support and saw improvement in both in this participant. CONCLUSION: BWSTT in combination with over ground training may improve gait and balance in a subject with severe ataxia secondary to TBI.