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Effects of body weight-support treadmill training on postural sway and gait independence in patients with chronic spinal cord injury.

ABSTRACT: OBJECTIVE:To examine the effects of a six-week body weight-support treadmill training (BWSTT) program on center-of-mass control and gait independence in chronic, incomplete spinal cord injury (iSCI) patients. DESIGN:Descriptive. SETTING:Clinica Los Coihues. Neurorehabilitation center in Santiago, Chile. PARTICIPANTS:17 chronic iSCI patients and 17 healthy subjects. OUTCOME MEASURES:An instrumented sway (ISway) test was performed before and after the implementation of a six-week BWSTT program. The standing balance of participants was measured by Normalized jerk (NJ) and root mean square (RMS). These values were used to assess the standing balance of participants, and were correlated with the scores obtained on the Walking Index Spinal Cord Injury (WISCI) II test. RESULTS:Significant differences were found in standing balance (i.e., through NJ) after the BWSTT program (P?=?0.016), but no significant differences were found in RMS values for postural sway (P?=?0.693). None of the patients obtained improved WISCI II scores pre- vs. post-intervention. CONCLUSION:While a BWSTT program can improve center-of-mass control in iSCI patients, no effects were recorded for gait independence. TRIAL REGISTRATION:National Clinical Trials, registry number NCT02703883.

SUBMITTER: Covarrubias-Escudero F

PROVIDER: S-EPMC6340274 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Effects of body weight-support treadmill training on postural sway and gait independence in patients with chronic spinal cord injury.

Covarrubias-Escudero Felipe F Rivera-Lillo Gonzalo G Torres-Castro Rodrigo R Varas-Díaz Gonzalo G

The journal of spinal cord medicine 20171023 1

<h4>Objective</h4>To examine the effects of a six-week body weight-support treadmill training (BWSTT) program on center-of-mass control and gait independence in chronic, incomplete spinal cord injury (iSCI) patients.<h4>Design</h4>Descriptive.<h4>Setting</h4>Clinica Los Coihues. Neurorehabilitation center in Santiago, Chile.<h4>Participants</h4>17 chronic iSCI patients and 17 healthy subjects.<h4>Outcome measures</h4>An instrumented sway (ISway) test was performed before and after the implementa ...[more]

PMID: 29058553

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Project description:Background and purposeSpared fibers after spinal cord injury (SCI) tend to consist predominantly of subcortical circuits that are not under volitional (cortical) control. We aim to improve function after SCI by using targeted physical exercises designed to simultaneously stimulate cortical and spared subcortical neural circuits.MethodsParticipants with chronic motor-incomplete SCI enrolled in a single-center, prospective interventional crossover study. Participants underwent 48 sessions each of weight-supported robotic-assisted treadmill training and a novel combination of balance and fine hand exercises, in randomized order, with a 6-week washout period. Change post-intervention was measured for lower extremity motor score, soleus H-reflex facilitation; seated balance function; ambulation; spasticity; and pain.ResultsOnly 9 of 21 enrolled participants completed both interventions. Thirteen participants completed at least one intervention. Although there were no statistically significant differences, multimodal training tended to increase short-interval H-reflex facilitation, whereas treadmill training tended to improve dynamic seated balance.DiscussionThe low number of participants who completed both phases of the crossover intervention limited the power of this study to detect significant effects. Other potential explanations for the lack of significant differences with multimodal training could include insufficient engagement of lower extremity motor cortex using skilled upper extremity exercises; and lack of skill transfer from upright postural stability during multimodal training to seated dynamic balance during testing. To our knowledge, this is the first published study to report seated posturography outcomes after rehabilitation interventions in individuals with SCI.ConclusionIn participants with chronic incomplete SCI, a novel mix of multimodal exercises incorporating balance exercises with skilled upper extremity exercises showed no benefit compared to an active control program of body weight-supported treadmill training. To improve participant retention in long-term rehabilitation studies, subsequent trials would benefit from a parallel group rather than crossover study design.

Dataset Information

Effects of body weight-support treadmill training on postural sway and gait independence in patients with chronic spinal cord injury.

Publications

Effects of body weight-support treadmill training on postural sway and gait independence in patients with chronic spinal cord injury.

Similar Datasets

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