Cargando…

Dynamic body-weight support to boost rehabilitation outcomes in patients with non-traumatic spinal cord injury: an observational study

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 imp...

Descripción completa

Detalles Bibliográficos
Autores principales: Huber, Justin P., Sawaki, Lumy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7706039/
https://www.ncbi.nlm.nih.gov/pubmed/33256797
http://dx.doi.org/10.1186/s12984-020-00791-2
_version_ 1783617070776188928
author Huber, Justin P.
Sawaki, Lumy
author_facet Huber, Justin P.
Sawaki, Lumy
author_sort Huber, Justin P.
collection PubMed
description 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 (FIM(gain)). RESULTS: During an inpatient rehabilitation course, participants in the experimental group (n = 11), achieved a mean (SD) FIM(gain) of 48 (11) points. For the historical control group (n = 11), participants achieved a mean (SD) FIM(gain) of 36 (12) points. From admission to discharge, both groups demonstrated a statistically significant FIM(gain). Between groups analysis revealed no significant difference in FIM(gain) (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.
format Online
Article
Text
id pubmed-7706039
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-77060392020-12-01 Dynamic body-weight support to boost rehabilitation outcomes in patients with non-traumatic spinal cord injury: an observational study Huber, Justin P. Sawaki, Lumy J Neuroeng Rehabil Research 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 (FIM(gain)). RESULTS: During an inpatient rehabilitation course, participants in the experimental group (n = 11), achieved a mean (SD) FIM(gain) of 48 (11) points. For the historical control group (n = 11), participants achieved a mean (SD) FIM(gain) of 36 (12) points. From admission to discharge, both groups demonstrated a statistically significant FIM(gain). Between groups analysis revealed no significant difference in FIM(gain) (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. BioMed Central 2020-11-30 /pmc/articles/PMC7706039/ /pubmed/33256797 http://dx.doi.org/10.1186/s12984-020-00791-2 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Huber, Justin P.
Sawaki, Lumy
Dynamic body-weight support to boost rehabilitation outcomes in patients with non-traumatic spinal cord injury: an observational study
title Dynamic body-weight support to boost rehabilitation outcomes in patients with non-traumatic spinal cord injury: an observational study
title_full Dynamic body-weight support to boost rehabilitation outcomes in patients with non-traumatic spinal cord injury: an observational study
title_fullStr Dynamic body-weight support to boost rehabilitation outcomes in patients with non-traumatic spinal cord injury: an observational study
title_full_unstemmed Dynamic body-weight support to boost rehabilitation outcomes in patients with non-traumatic spinal cord injury: an observational study
title_short Dynamic body-weight support to boost rehabilitation outcomes in patients with non-traumatic spinal cord injury: an observational study
title_sort dynamic body-weight support to boost rehabilitation outcomes in patients with non-traumatic spinal cord injury: an observational study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7706039/
https://www.ncbi.nlm.nih.gov/pubmed/33256797
http://dx.doi.org/10.1186/s12984-020-00791-2
work_keys_str_mv AT huberjustinp dynamicbodyweightsupporttoboostrehabilitationoutcomesinpatientswithnontraumaticspinalcordinjuryanobservationalstudy
AT sawakilumy dynamicbodyweightsupporttoboostrehabilitationoutcomesinpatientswithnontraumaticspinalcordinjuryanobservationalstudy