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 Journal, 2021 · DOI: https://doi.org/10.31616/asj.2020.0047 · Published: November 1, 2021

Spinal Cord Injury Assistive Technology Rehabilitation

Simple Explanation

This study investigates whether combining electrical stimulation (ES) with virtual reality (VR) training improves balance in people with incomplete spinal cord injury (iSCI). Participants will be split into three groups: VR with ES, VR with sham stimulation, and VR alone. The study will measure lower extremity muscle strength, balance, functional mobility, and quality of life before, immediately after, and one month after the four-week intervention period. The researchers hypothesize that the group receiving VR training augmented with ES will show the most significant improvements in all measured outcomes, and that these improvements will persist one month after the intervention.

Study Duration

4 weeks intervention, 1 month follow-up

Participants

48 iSCI participants

Evidence Level

Level 1, Randomized Controlled Trial

Key Findings

1
The trial aims to provide new knowledge regarding the effectiveness of electrical stimulation-augmented virtual reality training for balance improvement in iSCI patients.
2
The study seeks to determine if ES-augmented VR training improves lower extremity muscle strength, balance, functional mobility, and QOL in iSCI individuals.
3
The trial will assess outcomes using LEMS, TechnoBody ProKin, BBS, WISCI, and WHOQOL-BREF at pre-intervention, post-intervention, and follow-up stages.

Research Summary

The study is a single-blind, randomized controlled trial designed to assess the efficacy of electrical stimulation-augmented virtual reality (VR) training on balance, muscle strength, functional mobility, and quality of life in individuals with incomplete spinal cord injury (iSCI). Forty-eight participants with iSCI will be recruited and randomly assigned to one of three groups: VR with electrical stimulation, VR with sham stimulation, or VR alone. The interventions will occur thrice a week for four weeks. The primary outcomes, including lower extremity motor score, static and dynamic balance, Berg Balance Scale score, Walking Index for Spinal Cord Injury, and WHO Quality of Life-BREF, will be evaluated at pre-intervention, post-intervention, and at a one-month follow-up.

Practical Implications

Rehabilitation Program Design

The study results can contribute to designing better rehabilitation programs for individuals with iSCI by incorporating effective balance training strategies.

Clinical Practice

The findings can inform clinical practice by providing evidence-based protocols for improving balance and functional mobility in iSCI patients.

Technology Integration

The study promotes the integration of VR and ES technologies in rehabilitation settings to enhance patient outcomes.

Study Limitations

1
Single-blinded design (assessor only) due to the nature of the intervention.
2
Recruitment through a convenience sample from one rehabilitation center, potentially leading to selection bias.
3
The study is limited to individuals with incomplete spinal cord injury (iSCI).

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