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Interventions to Improve Standing Balance in Individuals With Incomplete Spinal Cord Injury: A Systematic Review and
Shefali Walia1,2, Pragya Kumar1, Chitra Kataria2
1Amity Institute of Physiotherapy, Amity University, Noida, Uttar Pradesh, India.
Topics in Spinal Cord Injury Rehabilitation
|May 26, 2023
Summary
Effective balance training for incomplete spinal cord injury (iSCI) remains unclear. Combining body weight-supported training (BWST) with stimulation shows promise, while virtual reality (VR) offers significant improvements needing further RCT validation.
Area of Science:
- Neurorehabilitation
- Physical Therapy
- Clinical Research
Background:
- Incomplete spinal cord injury (iSCI) frequently leads to balance impairments, hindering functional recovery.
- Restoring standing balance is crucial for daily activities and rehabilitation, yet effective training protocols are not well-defined.
- This study systematically reviews interventions aimed at improving standing balance in individuals with iSCI.
Approach:
- A comprehensive systematic search was conducted across major databases (SCOPUS, PEDro, PubMed, Web of Science).
- Methodological quality was assessed using the PEDro Scale for RCTs/crossover studies and the modified Downs and Black tool for pre-post trials.
- A meta-analysis was performed to quantitatively synthesize findings from included studies.
Key Points:
- Weak evidence supports body weight-supported training (BWST) for overground balance training in iSCI.
- Combining BWST with stimulation demonstrated significant improvements in standing balance.
- Virtual reality (VR) training showed significant improvements in Berg Balance Scale (BBS) scores in pre-post studies.
Conclusions:
- While BWST alone has limited support, BWST combined with stimulation presents a promising rehabilitation strategy.
- VR-based balance training shows potential but requires further validation through large-scale, high-quality randomized controlled trials (RCTs).
- Further well-designed RCTs are essential to establish optimal training parameters for enhancing standing balance in iSCI populations.
