Abstract
BackgroundDynamic 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).MethodsThis 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).ResultsDuring 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 FIMgain. 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.ConclusionsThis 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.
Highlights
Global greying is a profound, ongoing phenomenon [1]
The mean weight of these participants was 165 (37) pounds for the Dynamic body-weight support (DBWS) group and 264 (72) pounds for the historical controls, which was significantly different (p = 0.001; 95% CI 48.4–149.9)
The mean length of stay was 21 (12) for the DBWS group and 29 (31) for the historical control group. For both the historical controls and the experimental group, degenerative spine disease was a prominent etiology of non-traumatic spinal cord injury (64% in each group)
Summary
It refers to the disproportionate increase in our aged population Studies suggest this global greying is contributing to increased incidence of non-traumatic spinal. Individuals with NT-SCI at inpatient rehabilitation often have better function at admission versus individuals with traumatic SCI, functional outcomes are similar for both groups [10]. This has been attributed to the advanced age of persons with NT-SCI [4, 9, 11]. 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)
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