Abstract
Study design:
Randomized, assessor-blinded trial.
Objectives:
To evaluate the effectiveness of a 6-week task-specific training programme on the abilities of people with chronic spinal cord injuries to sit unsupported.
Setting:
NSW, Australia.
Methods:
Thirty adults with spinal cord injuries of at least 1-year duration were recruited. Participants in the training group (n=15) performed up to 1 h of task-specific training three times a week for 6 weeks. Participants in the control group (n=15) did not receive any training or additional therapy. Primary outcome measures were the Canadian Occupational Performance Measure (COPM), and tests of Upper Body Sway, Maximal Balance Range and donning and doffing a T-shirt (the T-shirt test).
Results:
The between-group mean difference (95% confidence interval) for the maximal balance range was 64 mm (95% confidence interval 20 to 108 mm; P=0.006). There were no significant between-group mean differences for the COPM and the Upper Body Sway and T-shirt tests.
Conclusions:
This trial shows initial support for intensive task-specific training for improving the abilities of people with chronic spinal cord injuries to sit unsupported, although the real-world implications of the observed treatment effects are yet to be determined.
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References
Seelen HAM, Potten YJM, Huson A, Spaans F, Reulen JPH . Impaired balance control in paraplegic subjects. J Electromyogr Kinesiol 1997; 7: 149–160.
Potten YJM, Seelen HAM, Drukker J, Reulen JPH, Drost MR . Postural muscle responses in the spinal cord injured persons during forward reaching. Ergonomics 1999; 42: 1200–1215.
Do M, Bouisset S, Moynot C . Are paraplegics handicapped in the execution of a manual task? Ergonomics 1985; 28: 1363–1375.
Dean CM, Shepherd RB . Task-related training improves performance of seated reaching tasks after stroke. Stroke 1997; 28: 722–728.
Carr JH, Shepherd RB . A Motor Relearning Programme for Stroke, 2nd edn. Butterworth-Heinemann: Oxford, 1987.
Maynard Jr F, Bracken M, Creasey G, Ditunno Jr J, Donovan W, Ducker T et al. International standards for neurological and functional classification of spinal cord injury. Spinal Cord 1997; 35: 266–274.
Boswell-Ruys CL, Sturnieks DL, Harvey LA, Sherrington C, Middleton JW, Lord SR . Validity and reliability of assessment tools for measuring unsupported sitting in people with a spinal cord injury. Arch Phys Med Rehab (in press, accepted 21 February 2009).
Law M, Baptiste S, McColl MA, Opzoomer A, Polatajko H, Pollock N . The Canadian Occupational Performance Measure: an outcome measure for occupational therapy. Can J Occup Ther 1990; 57: 82–87.
Lord S, Menz H, Tiedemann A . A physiological profile approach to falls risk assessment and prevention. Phys Ther 2003; 83: 237–252.
Yardley L, Beyer N, Hauer K, Kempen G, Piot-Ziegler C, Todd C . Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age Ageing 2005; 34: 614–619.
Law M, Baptiste S, Carswell A, McColl MA, Polatajko H, Pollock N . COPM–the Canadian Occupational Performance Measure. http://www.caot.ca/copm/questions.html. Last accessed on 29 July 2008.
Vickers AJ, Altman DG . Analysing controlled trials with baseline and follow up measurements. BMJ 2001; 323: 1123–1124.
Fergusson D, Aaron SD, Guyatt G, Hebert P . Post-randomisation exclusions: the intention to treat principle and excluding patients from analysis. BMJ 2002; 325: 652–654.
Harvey L, Lin C-W, Glinsky J, De Wolf A . The effectiveness of physical interventions for people with spinal cord injuries: a systematic review. Spinal Cord 2009; 47: 184–195.
Seelen HAM, Potten YJM, Drukker J, Reulen JPH, Pons C . Development of new muscle synergies in postural control in spinal cord injured subjects. J Electromyogr Kinesiol 1998; 8: 23–34.
Beekhuizen K, Field-Fote E . Massed practice versus massed practice with stimulation: effects on upper extremity function and cortical plasticity in individuals with incomplete cervical spinal cord injury. Neurorehabil Neural Repair 2005; 19: 33–45.
Harkema SJ, Hurley SL, Patel UK, Requejo PS, Dobkin BH, Edgerton VR . Human lumbosacral spinal cord interprets loading during stepping. J Neurophysiol 1997; 77: 797–811.
Field-Fote E . Spinal cord control of movement: implications for locomotor rehabilitation following spinal cord injury. Phys Ther 2000; 80: 477–484.
Dobkin B . Activity-dependent learning contributes to motor recovery. Ann Neurol 1998; 44: 158–160.
Wolpaw J, Tennissen A . Activity-dependent spinal cord plasticity in health and disease. Ann Rev Neurosci 2001; 24: 807–843.
Acknowledgements
This trial was supported by the NSW Premier's Spinal Cord Injury Grant Program and the National Health and Medical Research Council of Australia. We thank all our participants for giving up their time to make this trial possible.
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Boswell-Ruys, C., Harvey, L., Barker, J. et al. Training unsupported sitting in people with chronic spinal cord injuries: a randomized controlled trial. Spinal Cord 48, 138–143 (2010). https://doi.org/10.1038/sc.2009.88
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DOI: https://doi.org/10.1038/sc.2009.88
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