Functional Electrical Stimulation Plus Visual Feedback Balance Training for Standing Balance Performance Among Individuals With Incomplete Spinal Cord Injury: A Case Series

Frontiers in Neurology, 2020 · DOI: 10.3389/fneur.2020.00680 · Published: July 23, 2020

Spinal Cord Injury Neurorehabilitation Rehabilitation

Simple Explanation

This study explores a new therapy for improving standing balance in people with incomplete spinal cord injuries (iSCI). The therapy combines functional electrical stimulation (FES) with visual feedback balance training (VFBT). FES uses electrical currents to activate weakened muscles, while VFBT uses visual displays to help people control their balance. Five adults with iSCI participated in 12 training sessions over four weeks. They performed balance exercises while receiving FES and watching a visual representation of their center-of-pressure (COP) location. The FES system automatically adjusted the electrical current based on the COP location. The study found that FES+VFBT has potential as a therapy for standing balance after iSCI. Participants reported that the ability to practice challenging balance exercises safely was an important component of the training.

Study Duration

4 weeks

Participants

5 adults with motor incomplete spinal cord injury

Evidence Level

Case Series

Key Findings

1
Improvements were seen for four of the five participants on at least one of the clinical scales following completion of the training intervention.
2
All participants showed greater maximal COP excursion area during the limits of stability test after the training intervention.
3
Specific components of FES+VFBT, including the ability to safely practice challenging balance exercises, were deemed important by the participants.

Research Summary

This study evaluated functional electrical stimulation plus visual feedback balance training (FES+VFBT) for standing balance control in five individuals with chronic, motor incomplete spinal cord injury (iSCI). The participants completed 12 FES+VFBT sessions over 4 weeks. Balance abilities were assessed pre- and post- training using clinical balance scales and biomechanical assessments. Improvements were seen in clinical balance scales and biomechanical measures of balance. Participants found the program helpful and safe, but indicated that they would have liked a longer intervention period.

Practical Implications

Potential Therapeutic Tool

FES+VFBT shows potential as a therapeutic tool for improving standing balance in individuals with iSCI.

Safe Practice Environment

The program provides a safe environment to practice challenging balance exercises, which participants found important.

Further Research Needed

Larger randomized controlled trials are needed to further evaluate the efficacy of FES+VFBT and determine optimal training parameters.

Study Limitations

1
The characteristics of the studied sample do not reflect the characteristics of the larger SCI population in Canada.
2
The experimental design of the study could also be considered a limitation.
3
As this is a case series, it is not possible to draw conclusions on the efficacy of the FES+VFBT intervention for standing balance among individuals with SCI.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury