A. Arun1, L. John1, S.K. Durairaj1
1Christian Medical College, Vellore, Physiotherapy, Department of Physical Medicine and Rehabilitation, Vellore, India
Background: Spinal cord injury results in impairment of motor, sensory, and autonomic systems. Unsupported sitting is an important component in spinal cord injury patients to carry out most of their activities of daily living. Sitting balance can be improved by task-specific training and goal-based exercises etc. Medicine ball exercise is a challenging intervention that can be used to improve muscle strength, muscle power, coordination, and balance. In this study, we attempted to find the effectiveness of medicine ball exercises in sitting balance in person with spinal cord injury level T1 to T12.
Purpose: In spinal cord injury, extensive paralysis of the trunk muscles renders sitting unsupported difficult and requires the use of non-paralyzed muscles to maintain the center of mass over the base of support. The ability to sit unsupported can be improved in persons by intensive and appropriate therapy. Task-specific training is the most commonly used therapy. Medicine ball training is a conventional training method in healthy adults and athlete populations. In this study, we have attempted to evaluate the effectiveness of medicine ball training in patients with spinal cord injury T1 to T12. The primary objective was to evaluate the change in Modified Functional Reach Test (MFRT) and the secondary objective was to evaluate the unsupported sitting duration following medicine ball intervention.
Methods: 34 Persons with thoracic level spinal cord injury (T1 to T12) satisfying the inclusion criteria were selected and randomly allocated into control (n=17) and experimental group (n=17) by computer-generated random allocation method. The assessor was blinded to the groups. The intervention was for 40 minutes / day for 5 days a week for 2 consecutive weeks. The experimental group underwent medicine ball training with a focus on sitting balance. The control group was subjected to conventional balance training involving static-sitting postures (diamond sitting), long sitting and high sitting with upper limb support. The experimental group had different levels of graded challenging exercises involving medicine ball Eg., weight transfer between arms to diagonal throw of medicine ball. The primary outcome measure used in this study was the Modified Functional Reach Test (MFRT) and the secondary outcome measure was the duration of high sitting with arms at chest level without any support measured in seconds. The data was analyzed using a dependent 't' and independent t' test.
Results: The control group did not show a statistically significant difference in the Modified Functional Reach Test (p-value = 0.085). The control group showed a statistically significant difference in unsupported sitting duration (p-value = 0.012). The experimental group showed a statistically significant difference in both MFRT and Unsupported sitting duration (p-value = 0.018 and 0.012 respectively). Comparing the post interventional values for both the groups there was a statistically significant difference in the unsupported sitting duration (p-value = 0.026), Whereas the MFRT did not show a statistically significant difference (p-value =0.441).
Conclusion(s): The data suggests that medicine ball training improves sitting balance in persons with thoracic-level paraplegia.
Implications: This study highlights the usefulness of weighted ball training program in improving sitting balance in persons with thoracic-level paraplegia.
Funding, acknowledgements: This research work was supported by the Institutional Fluid Research Grant at Christian Medical College, Vellore, India.
Keywords: paraplegia, sitting-balance, medicine ball
Topic: Neurology: spinal cord injury
Did this work require ethics approval? Yes
Institution: Christian Medical College, Vellore, India
Committee: Institutional Review Board
Ethics number: IRB Min 8256/2013
All authors, affiliations and abstracts have been published as submitted.
