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

Objectives: (1) To evaluate the learning potential and performance improvements during standing balance training with visual feedback (VBT) in individuals with incomplete spinal cord injury (SCI) and (2) to determine whether standing static and dynamic stability during training-irrelevant tasks can be improved after the VBT. Setting: National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan. Methods: Six participants with chronic motor and sensory incomplete SCI who were able to stand for at least 5 min without any form of assistive device performed the VBT, 3 days per week, for a total of 12 sessions. During the training, participants stood on a force platform and were instructed to shift their center of pressure in the indicated directions as represented by a cursor on a monitor. The performance and the rate of learning were monitored throughout the training period. Before and after the program, static and dynamic stability was assessed. Results: All participants showed substantial improvements in the scores, which varied between 236 +/- 94 and 130 +/- 14% of the initial values for different exercises. The balance performance during training-irrelevant tasks was significantly improved: for example, the area inside the stability zone after the training reached 221 +/- 86% of the pre-training values. Conclusion: Postural control can be enhanced in individuals with incomplete SCI using VBT. All participants showed substantial improvements during standing in both game performance and training-irrelevant tasks after the VBT. Spinal Cord (2010) 48, 886-893; doi:10.1038/sc.2010.41; published online 20 April 2010