Game-based Exercises for Dynamic Short-Sitting Balance Rehabilitation of People With Chronic Spinal Cord and Traumatic Brain Injuries

Abstract

Background and Purpose Goal-oriented, task-specific training has been shown to improve function; however, it can be difficult to maintain patient interest. This report describes a rehabilitation protocol for the maintenance of balance in a short-sitting position following spinal cord and head injuries by use of a center-of-pressure–controlled video game–based tool. The scientific justification for the selected treatment is discussed. Case Descriptions Three adults were treated: 1 young adult with spina bifida (T10 and L1–L2), 1 middle-aged adult with complete paraplegia (complete lesion at T11–L1), and 1 middle-aged adult with traumatic brain injury. All patients used wheelchairs full-time. Outcomes The patients showed increased motivation to perform the game-based exercises and increased dynamic short-sitting balance. Discussion The patients exhibited increases in practice volume and attention span during training with the game-based tool. In addition, they demonstrated substantial improvements in dynamic balance control. These observations indicate that a video game–based exercise approach can have a substantial positive effect by improving dynamic short-sitting balance.

Positive effect of balance training with visual feedback on standing balance abilities in people with incomplete spinal cord injury

“…[14][15][16] Presumably, an increase in cortical control of muscles after incomplete SCI might allow functional recovery through the development of alternative movement strategies. 25 As a result, the motor programs for balance control strategies, provided by task-specific training, seemed to be effective and could affect the final outcome of the participants in our study.…”

“…7 Although further studies are needed to investigate a potential association between positive results obtained from laboratory force plate measures and clinical and functional outcomes, 6,9 it has been shown that the main positive effect of such training on postural control can be attributed to sensorimotor integration 5,[10][11][12][13] as well as the coordination improvement because of the task specificity of training. 14,15 In the SCI population, benefits of game-based exercises 16 and virtual reality 3 have been suggested for dynamic sitting balance. These studies have shown their potential for substantial improvements in sitting balance through the inclusion of functional approaches in the training.…”

“…These studies have shown their potential for substantial improvements in sitting balance through the inclusion of functional approaches in the training. 3,16 However, the effect of balance training with visual feedback during standing in the SCI population has not been reported well. It has been suggested that the standing posture has a number of therapeutic and functional benefits 17 aimed at overcoming physiological problems, such as bladder infections, 17 spasticity, 18 blood pressure homeostasis, 19 and bone demineralization.…”

Effect of Mental Training on the Balance Control Ability of Healthy Subjects

“…In particular, balance dysfunction is a very important issue in the elderly. Numerous therapeutic interventions have been attempted in order to improve the postural control ability of elderly adults and various types of patients 6,8,9,30) . Our findings show that mental practice with motor imagery can provide an effective and safe training method for individuals with balance dysfunction.…”

“…Balance-related problems lead to considerable health problems and social incur services costs, because of the patient's dependence on basic functional activities 5) . In order to improve balance ability, many studies have adopted a wide range of training methods involving balance training with visual feedback, muscle strength training, plyometric, virtual reality, and mental training [6][7][8][9][10] .…”