Dynamic body-weight support to boost rehabilitation outcomes in patients with non-traumatic spinal cord injury: an obser
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Dynamic body‑weight support to boost rehabilitation outcomes in patients with non‑traumatic spinal cord injury: an observational study Justin P. Huber1,2 and Lumy Sawaki1,3*
Abstract Background: Dynamic body-weight support (DBWS) may play an important role in rehabilitation outcomes, but the potential benefit among disease-specific populations is unclear. In this study, we hypothesize that overground therapy with DBWS during inpatient rehabilitation yields greater functional improvement than standard-of-care in adults with non-traumatic spinal cord injury (NT-SCI). Methods: This retrospective cohort study included individuals diagnosed with NT-SCI and undergoing inpatient rehabilitation. All participants were recruited at a freestanding inpatient rehabilitation hospital. Individuals who trained with DBWS for at least three sessions were allocated to the experimental group. Participants in the historical control group received standard-of-care (i.e., no DBWS). The primary outcome was change in the Functional Independence Measure scores (FIMgain). Results: During an inpatient rehabilitation course, participants in the experimental group (n = 11), achieved a mean (SD) FIMgain of 48 (11) points. For the historical control group (n = 11), participants achieved a mean (SD) FIMgain of 36 (12) points. From admission to discharge, both groups demonstrated a statistically significant F IMgain. Between groups analysis revealed no significant difference in FIMgain (p = 0.022; 95% CI 2.0–22) after a post hoc correction for multiple comparisons. In a secondary subscore analysis, the experimental group achieved significantly higher gains in sphincter control (p = 0.011: 95% CI 0.83–5.72) with a large effect size (Cohen’s d 1.19). Locomotion subscores were not significantly different (p = 0.026; 95% CI 0.37–5.3) nor were the remaining subscores in self-care, mobility, cognition, and social cognition. Conclusions: This is the first study to explore the impact of overground therapy with DBWS on inpatient rehabilitation outcomes for persons with NT-SCI. Overground therapy with DBWS appears to significantly improve functional gains in sphincter control compared to the standard-of-care. Gains achieved in locomotion, mobility, cognition, and social cognition did not meet significance. Findings from the present study will benefit from future large prospective and randomized studies. Keywords: Locomotion, Neuroplasticity, Functional independence measure, Therapeutic technology
*Correspondence: [email protected] 1 Department of Physical Medicine and Rehabilitation, University of Kentucky, 2050 Versailles Road, Lexington, KY 40504, USA Full list of author information is available at the end of the article
Introduction Global greying is a profound, ongoing phenomenon [1]. It refers to the disproportionate increase in our aged population. Studies suggest this global greying is contributing to increased incidence of non-traumatic spinal
© The Author(s) 2020. Open Access This article is licensed under a Creative
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