Medicine & Science in Sports & Exercise:
B-29 Free Communication/Poster - Neuromuscular Control, Balance, and Gait: MAY 30, 2007 1:00 PM - 6:00 PM ROOM: Hall E
University of Findlay, Findlay, OH.
Research and current therapy for patients with an incomplete spinal cord injury (iSCI) as a result of spinal shock focuses on the recovery of strength and independence in activities of daily living within a one year time frame after a trauma. However, functional community activities involving gait and balance - such as walking distances sufficient to conduct business in a variety of locations, ascending and descending curbs, as well as crossing a street within the time provided by a crossing signal - are often overlooked. This study addressed the balance and gait skills required to overcome these obstacles in a chronic patient (18-months post-accident) with an iSCI; a time frame when additional functional gains are often considered very small.
PURPOSE: To examine the effectiveness of a 6-week balance training program in a patient with an iSCI 18 months after trauma and spinal shock for safer community integration.
METHODS: The patient's gait and balance were assessed and measured through the Berg Balance Scale (BBS), Dynamic Gait Index (DGI), Borg's Rate of Perceived Exertion Scale (RPE), and the Short-Form 36 (SF-36) one-year post-accident, 18 months post-accident pre-treatment, and post-treatment. Treatment included 6 weeks of intense static and dynamic sitting and standing balance activities to increase proprioception and decrease reliance on visual cues - deficits which were not addressed during past initial rehabilitation programs.
RESULTS: Dramatic gains were shown in all outcome measurements. The BBS increased from 43 (one-year post-accident) to 49 (18 months post-accident pre-treatment) to a perfect 56 (post-treatment) out of 56. The DGI improved from 12 to 11 to a normal 24 out of 24 respectively. The RPE was evaluated on a half mile walk and decreased from 17 to 12 to 11 with each testing date - indicating a significant decrease in energy expenditure with activity. The SF-36 reported quality of life improvements in all 8 areas of physical function, physical role function, emotional role function, social function, bodily pain, mental health, vitality, and general health.
CONCLUSIONS: Balance and gait training during the chronic stages (> 1 year) of an iSCI as a result of spinal shock can be surprisingly effective in reintegrating a patient safely back into the community.