The effects of backward walking training on balance and mobility in an individual with chronic incomplete spinal cord injury: A case report

Foster, Hannah; DeMark, Lou; Spigel, Pamela M.; Rose, Dorian K.; Fox, Emily J.

doi:10.1080/09593985.2016.1206155

Cited by 38 publications

(19 citation statements)

References 60 publications

(96 reference statements)

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“…Although no studies specifically investigated the effects of task-specific PBT in the incomplete SCI population, improvements in similar outcome measures were seen with 34 various types of training. Foster,et al found improvements in balance, balance confidence, and functional mobility measured by the TUG in the incomplete SCI population, but were a result of performing backward walking training compared to the PBT performed in this case 35 report.…”

Section: Discussionmentioning

confidence: 99%

Impact of Perturbation-Based Balance Training on Functional Outcomes in a Patient with Chronic Incomplete Spinal Cord Injury: A Case Report

Drake¹,

Mowder-Tinney²

2017

Phys Med Rehabil

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Section: Discussionmentioning

confidence: 99%

Impact of Perturbation-Based Balance Training on Functional Outcomes in a Patient with Chronic Incomplete Spinal Cord Injury: A Case Report

Drake¹,

Mowder-Tinney²

2017

Phys Med Rehabil

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“…These studies demonstrated that tsDCS could indeed modulate spinal cord function (17,19,20,29,31,32,59,60), raising the question whether it could also influence locomotor behavior. In this investigation, we used the same montage and stimulating parameters reported to modulate electrophysiological measures of spinal cord function to address a novel question: could tsDCS modulate locomotor behavior in the form of learning a novel backward task of relevance in sports medicine and neurorehabilitation (61)(62)(63)(64)(65)(66)(67)(68)(69)(70). Additionally, we confirmed that under our experimental conditions tsDCS modulated spinal cord function in the form of excitability of the alpha motoneuron pool.…”

Section: Discussionmentioning

confidence: 99%

Transcutaneous spinal direct current stimulation improves locomotor learning in healthy humans

Awosika

Sandrini

Volochayev³

et al. 2019

Brain Stimulation

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Background: Ambulation is an essential aspect of daily living and is often impaired after brain and spinal cord injuries. Despite the implementation of standard neurorehabilitative care, locomotor recovery is often incomplete. Objective: In this randomized, sham-controlled, double-blind, parallel design study, we aimed to determine if anodal transcutaneous spinal direct current stimulation (anodal tsDCS) could improve training effects on locomotion compared to sham (sham tsDCS) in healthy subjects. Methods: 43 participants underwent a single backwards locomotion training (BLT) session on a reverse treadmill with concurrent anodal (n=22) or sham (n=21) tsDCS. The primary outcome measure was speed gain measured 24 hours post-training. We hypothesized that anodal tsDCS+BLT would improve training effects on backward locomotor speed compared to sham tsDCS+BLT. A subset of participants (n=31) returned for two additional training days of either anodal (n=16) or sham (n=15) tsDCS and underwent (n=29) H-reflex testing immediately before, immediately after, and 30 minutes post-training over three consecutive days. Results: A single session of anodal tsDCS+BLT elicited greater speed gain at 24 hours relative to sham tsDCS+BLT (p=0.008, two-sample t-test, adjusted for one interim analysis after the initial 12 subjects). Anodal tsDCS+BLT resulted in higher retention of the acquired skill at day 30 relative to sham tsDCS+BLT (p=0.002) in the absence of significant group differences in online or offline learning over the three training days (p=0.467 and p=0.131). BLT resulted in transient down-regulation of H-reflex amplitude (Hmax/Mmax) in both test groups (p<0.0001). However, the concurrent application of anodal-tsDCS with BLT elicited a longer lasting effect than sham-tsDCS+BLT (p=0.050). Conclusion: TsDCS improved locomotor skill acquisition and retention in healthy subjects and prolonged the physiological exercise-mediated downregulation of excitability of the alpha motoneuron pool. These results suggest that this strategy is worth exploring in neurorehabilitation of locomotor function.

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“…Consistent with this, recent reports of backward walking training in individuals with ISCIs suggest this strategy may be useful for promoting recovery of balance and forward walking function. [ 48 , 49 ]…”

Section: Discussionmentioning

confidence: 99%

Retraining walking adaptability following incomplete spinal cord injury

Fox

Tester

Butera

et al. 2017

Spinal Cord Ser Cases

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IntroductionFunctional walking requires the ability to modify one’s gait pattern to environmental demands and task goals—gait adaptability. Following incomplete spinal cord injury (ISCI), gait rehabilitation such as locomotor training (Basic-LT) emphasizes intense, repetitive stepping practice. Rehabilitation approaches focusing on practice of gait adaptability tasks have not been established for individuals with ISCIs but may promote recovery of higher level walking skills. The primary purpose of this case series was to describe and determine the feasibility of administering a gait adaptability retraining approach—Adapt-LT—by comparing the dose and intensity of Adapt-LT to Basic-LT.Case presentationThree individuals with ISCIs (>1 year, AIS C or D) completed three weeks each (15 sessions) of Basic-LT and Adapt-LT. Interventions included practice on a treadmill with body weight support and practice overground (≥30 mins total). Adapt-LT focused on speed changes, obstacle negotiation, and backward walking. Training parameters (step counts, speeds, perceived exertion) were compared and outcomes assessed pre and post interventions. Based on completion of the protocol and similarities in training parameters in the two interventions, it was feasible to administer Adapt-LT with a similar dosage and intensity as Basic-LT. Additionally, the participants demonstrated gains in walking function and balance following each training type.DiscussionRehabilitation that includes stepping practice with adaptability tasks is feasible for individuals with ISCIs. Further investigation is needed to determine the efficacy of Adapt-LT.

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The effects of backward walking training on balance and mobility in an individual with chronic incomplete spinal cord injury: A case report

Cited by 38 publications

References 60 publications

Impact of Perturbation-Based Balance Training on Functional Outcomes in a Patient with Chronic Incomplete Spinal Cord Injury: A Case Report

Impact of Perturbation-Based Balance Training on Functional Outcomes in a Patient with Chronic Incomplete Spinal Cord Injury: A Case Report

Transcutaneous spinal direct current stimulation improves locomotor learning in healthy humans

Retraining walking adaptability following incomplete spinal cord injury

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