Current state of balance assessment during transferring, sitting, standing and walking activities for the spinal cord injured population: A systematic review

Abstract

Context Comprehensive balance measures with high clinical utility and sound psychometric properties are needed to inform the rehabilitation of individuals with spinal cord injury (SCI). Objective To identify the balance measures used in the SCI population, and to evaluate their clinical utility, psychometric properties and comprehensiveness. Methods Medline, PubMed, Embase, Scopus, Web of Science, and the Allied and Complementary Medicine Database were searched from the earliest record to October 19/16. Two researchers independently screened abstracts for articles including a balance measure and adults with SCI. Extracted data included participant characteristics and descriptions of balance measures. Quality was evaluated by considering study design, sampling method and adequacy of description of research participants. Clinical utility of all balance measures was evaluated. Comprehensiveness was evaluated using the modified Systems Framework for Postural Control. Results 2820 abstracts were returned and 127 articles included. Thirty-one balance measures were identified; 11 evaluated a biomechanical construct and 20 were balance scales. All balance scales had high clinical utility. The Berg Balance Scale and Functional Reach Test were valid and reliable, while the mini-BESTest was the most comprehensive. Conclusion No single measure had high clinical utility, strong psychometric properties and comprehensiveness. The mini-BESTest and/or Activity-based Balance Level Evaluation may fill this gap with further testing of their psychometric properties.

Care and research for spinal cord injury: A changing landscape

“…In this issue, researchers explore new ways to treat the sequelae of spinal cord injury, including respiratory compromise 6 and balance deficits. 7 and weight gain, 8 as well as an association between spinal cord injury and cognitive impairments, 9 generating interest in the interrelatedness of co-morbidities.…”

Spinal kord hasarlı hastanın rehabilitasyonu

“…Yapılan çalışmalarda, %34-75 oranında OY hastasının en az bir kez düştüğü saptanmıştır. [7] Ambulasyon için komplet torakal seviye yaralanmalı hastalarda diz ve ayak bileğini destekleyecek diz -ayak bilek -ayak ortezlerine ihtiyaç vardır. Sadece terapötik ambulasyon yapılacak hastalarda diz eklemini destekleyecek bir posterior-shell ve dorsifleksör bant yeterli olabilir.…”

Postural Control Strategy After Incomplete Spinal Cord Injury: Effect of Sensory Inputs on Trunk-leg Movement Coordination

“…iSCI affects the ability to safely stand and perform functional activities in this position [8]. The literature has reported a high occurrence of falling among the SCI population, with up to 78% of these individuals experience at least one fall post-rehabilitation [9][10][11]. Falls can lead to injuries and hospitalization [9], restriction in community participation [10,12,13], and a fear of falling [14].…”

“…The literature has reported a high occurrence of falling among the SCI population, with up to 78% of these individuals experience at least one fall post-rehabilitation [9][10][11]. Falls can lead to injuries and hospitalization [9], restriction in community participation [10,12,13], and a fear of falling [14]. One of the major factors contributing to falls in this population is the loss of balance [8,13], highlighting the lack of effective postural control in individuals with iSCI.…”

“…Effective postural control is obtained via the integration of sensory information [7] and the interaction of the body with the changing environment [9]. Due to the sensory and motor impairments at and below the level of the lesion post-SCI [8], sensory reweighting may be affected.…”