Static Balance Rehabilitation in Individuals with Incomplete Spinal Cord Injury
Abstract
Spinal cord injury (SCI) is damage to the tight bundle of cells and nerves that send and receive signals from the brain to and from the rest of the body. SCI can be caused by direct injury to the spinal cord itself or from damage to the tissue and bones that surround it. Patients with SCI often experience motor, sensory and/or respiratory dysfunction, as well as bladder, bowel and/or sexual dysfunction. An incomplete injury means that the spinal cord is still able to transmit certain messages to and from the brain to the rest of the body. Balance dysfunctions are one of the most prevalent impairments post incomplete SCI (iSCI). Static balance is also one of the major determinants of walking function; therefore, discovering effective strategies to improve static balance in this population is significant.
The purpose of this review is to highlight the importance of static balance rehabilitation in individuals with iSCI, as well as to describe effective modes of balance training in this population.
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References
Bickenbach J, Bodine C, Brown D, et al. International Perspectives on Spinal Cord Injury. Geneva, Switzerland. World Health Organization. 2013. Available via https://apps.who.int/iris/bitstream/handle/10665/94190/9789241564663_eng.pdf
Nijendijk J, Post M, van Asbeck F. Epidemiology of traumatic spinal cord injuries in the Netherlands in 2010. Spinal Cord 2014;52:258
McDonald J, Sadowsky C. Spinal-cord injury. The Lancet 2002;359:417–25.
Brotherton S, Krause J, Nietert P. Falls in individuals with incomplete spinal cord injury. Spinal Cord 2006;45:37–40.
Hsieh C, Sheu C, Hsueh I et al. Trunk control as an early predictor of comprehensive activities of daily living function in stroke patients. Stroke2002;33:2626–30.
Alashram AR, Padua E, Hammash AK, et al. Effectiveness of virtual reality on balance ability in individuals with incomplete spinal cord injury: A systematic review. Journal of Clinical Neuroscience 2020;72:322-27. 10.1016/j.jocn.2020.01.037
Maurer C, Mergner T, Peterka RJ. Multisensory control of human upright stance. Exp Brain Res 2006;171:231–50.10.1007/s00221-005-0256-y
Lemay JF, Gagnon D, Duclos C et al. Influence of visual inputs on quasi-static standing postural steadiness in individuals with spinal cord injury. Gait Posture 2013;38:357–60.10.1016/j.gaitpost.2012.11.029
Arora T, Musselmana KE, Lanovaz J et al. Effect of haptic input on standing balance among individuals with incomplete spinal cord injury. Neuroscience Letters 2017; 642:91–96.10.1016/j.neulet.2017.02.001
Chhabra H, Harvey L, Muldoon S et al. www.elearnSCI.org: a global educational initiative of ISCoS. Spinal Cord 2013;51:176–82. 10.1038/sc.2012.177
Dietz V, Muller R, Colombo G. Locomotor activity in spinal man: significance of afferent input from joint and load receptors. Brain 2002;125:2626-34.10.1093/brain/awf273
Harvey L. Training motor tasks. In: Management of spinal cord injuries. Churchill Livingstone, Edinburgh 2008:137-54.
Harkema SJ, Schmidt-Read M, Behrman AL et al. Establishing the NeuroRecovery Network: multisite rehabilitation centers that provide activity-based therapies and assessments for neurologic disorders. Arch Phys Med Rehabil 2012;93:1498-507.10.1016/j.apmr.2011.01.023
Van Hedel HJ, Dietz V. Rehabilitation of locomotion after spinal cord injury. Restor Neurol Neurosci2010;28:123-34.10.3233/RNN-2010-0508
Harkema SJ, Schmidt-Read M, Lorenz DJ et al. Balance and ambulation improvements in individuals with chronic incomplete spinal cord injury using locomotor training–based rehabilitation. Arch Phys Med Rehabil2012;93:1508-17.10.1016/j.apmr.2011.01.024
Lotter JK, Henderson CH, Plawecki A, et al.Task-specific versus impairment-basedtraining on locomotor performance in individuals with chronic spinal cord injury: a randomized crossover study. Neurorehabil Neural Repair 2020;34:627-39.10.1177/1545968320927384
Neville BT, Murray D, Rosen KB, et al.Effects of performance-based training on gait and balance in individuals with incomplete spinal cord injury. ArchPhys Med and Rehabil2019;100:1888-93.10.1016/j.apmr.2019.03.019
Shin JC, Jeon HR, Kim D, et al. Effects on the motor function, proprioception, balance, and gait ability of the end-effector robot-assisted gait training for spinal cord injury patients. Brain Sci 2021;11:1281.10.3390/brainsci11101281
Alexeeva N, Sames C, Jacobs PL, et al. Comparison of training methods to improvewalking in persons with chronic spinal cord injury: a randomized clinical trial. J Spinal Cord Med 2011;34:362-79. 10.1179/2045772311Y.0000000018
Fritz SL, Merlo-Rains AM, Rivers ED, et al. An intensive intervention for improving gait, balance, and mobility in individuals with chronic incomplete spinal cordinjury: a pilot study of activity tolerance and benefits. Arch Phys Med Rehabil 2011; 92:1776-84.10.1016/j.apmr.2011.05.006
Martinez SA, Nguyen ND, Bailey E, et al. Multimodal cortical and subcortical exercisecompared with treadmill training for spinal cord injury. PLoS ONE 2018; 13:e0202130.10.1371/journal.pone.0202130
Nam KY, Kim HJ, Kwon BS, et al. Robot-assisted gait training (Lokomat) improves walking function and activity in people with spinal cord injury: a systematic review. J NeuroengRehabil2017;14:24.10.1186/s12984-017-0232-3
Alashram AR, Annino G, Padua E. Robot-assisted gait training in individuals with spinal cord injury: A systematic review for the clinical effectiveness of Lokomat. J Clin Neurosci2021;91:260–69.10.1016/j.jocn.2021.07.019
Piira A, Lannem A, Sørensen M et al. Robot assisted locomotor training did not improve walking function in patients with chronic incomplete spinal cord injury: a randomized clinical trial. J Rehabil Med 2019;51:385–89. 10.2340/16501977-2547
Shahin AA, Shawky SA, Rady HM, et al. Effect of robotic assisted gait training on functional and psychological improvement in patients with incomplete Spinal Cord Injury. J Nov Physiother Phys Rehabil 2017;4:83–86. https://www.peertechzpublications.com/articles/JNPPR-4-153.php
Labruyère R, van Hedel HJA. Strength training versus robot-assisted gait training after incomplete spinal cord injury: a randomized pilot study in patients depending on walking assistance. J Neuro Eng Rehabil 2014;11:4.10.1186/1743-0003-11-4
Khan AS, Livingstone DC, Hurd CL et al. Retraining walking over ground in a powered exoskeleton after spinal cord injury: a prospective cohort study to examine functional gains and neuroplasticity. J Neuro Engin Rehabil 2019; 16:145. 10.1186/s12984-019-0585-x
Calabrò RS, Billeri L, Ciappina F, et al. Toward improving functional recovery in spinal cord injury using robotics: a pilot study focusing on ankle rehabilitation. Expert Rev Med Devices 2022;19:83-95.10.1080/17434440.2021.1894125
Marquez Chin C, Popovic MR. Functional electrical stimulation therapy for restoration of motor function after spinal cord injury and stroke: a review. BioMed EngOnLine2020; 19:34. 10.1186/s12938-020-00773-4
Audu ML, Lombardo LM, Schnellenberger JR, et al. A neuroprosthesis for control of seated balance after spinal cord injury. J NeuroengRehabil2015;12:8. 10.1186/1743-0003-12-8
Houston DJ, Lee JW, Unger J et al. Functional electrical stimulation plus visual feedback balance training for standing balance performance among individuals with incomplete spinal cord injury: a case series. Front Neurol 2020; 11:680. 10.3389/fneur.2020.00680
An CM, Park YH. The effects of semi-immersive virtual reality therapy on standing balance and upright mobility function in individuals with chronic incomplete spinal cord injury: a preliminary study. J Spinal Cord Med 2018; 41:223-29. 10.1080/10790268.2017.1369217
Wall T, Feinn R, Chui K, et al. The effects of the Nintendo™ Wii Fit on gait, balance, and quality of life in individuals with incomplete spinal cord injury. J Spinal Cord Med 2015;38:777-83.10.1179/2045772314Y.0000000296
Walia S, Kumar P, Kataria C. Efficacy of electrical stimulation-augmented virtual reality training in improving balance in individuals with incomplete spinal cord injury: study protocol of a randomized controlled trial. Asian Spine J2021;5:865-73. 10.31616/asj.2020.0047
Villiger M, Liviero J, Awai L et al. Home-based virtual reality-augmented trainingimproves lower limb muscle strength, balance, and functional mobility following chronic incomplete spinal cord injury. Front Neurol 2017;8:635.10.3389/fneur.2017.00635
Sayenko DG, Alekhina MI, Masani K, et al. Positive effect of balance training with visual feedback on standing balance abilities in people with incomplete spinal cord injury. Spinal Cord 2010;48:886–93.10.1038/sc.2010.41
Tamburella F, Scivoletto G, Molinari M. Balance training improves static stability and gait in chronic incomplete spinal cord injury subjects: a pilot study. Eur J of Phys Rehabil Med 2013;49:353-64 .https://pubmed.ncbi.nlm.nih.gov/23486301/
Unger J, Chan K, Scovil CY, et al. Intensive balance training for adults with incomplete spinal cord injuries: protocol for an assessor-blinded randomized clinical trial. Phys Ther2019;99:420–27.10.1093/ptj/pzy153
Chan K, Lee JW, Unger J, et al. Reactive stepping after a forward fall in people living with incomplete spinal cord injury or disease. Spinal Cord 2020;58:185-93.10.1038/s41393-019-0332-y
Unger J, Chan K, Lee JW et al. The effect of perturbation-based balance trainingand conventional intensive balance training on reactive stepping ability in individuals with incomplete spinal cord injury or disease: a randomized clinical trial. Front Neurol 2021;12:620367.10.3389/fneur.2021.620367
In T, Jungb K, Leec M, et al. Whole-body vibration improves ankle spasticity, balance, and walking ability. NeuroRehabilitation 2018; 42:491-497. 10.3233/NRE-172333
Williams AMM, Chisholm AE, Lynn A et al. Arm crank ergometer “spin” training improves seated balance and aerobic capacity in people with spinal cord injury. Scand J Med Sci Sports 2020;30:361-69.10.1111/sms.13580
Stevens SL, Caputo JL, Fuller DK, et al. Effects of underwater treadmill training on legstrength, balance, and walking performance in adults with incomplete spinal cord injury. J Spinal Cord Med 2015;38:91-101.10.1179/2045772314Y.0000000217
Marinho-Buzelli AR, Rouhani H, Craven BC et al. Effects of water immersion on quasi-static standing exploring center of pressure sway and trunk acceleration: a case series after incomplete spinal cord injury. Spinal Cord Ser Cases 2019;5:5. 10.1038/s41394-019-0147-2
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