A STUDY TO COMPARE THE EFFECTIVENESS OF TRUNK TRAINING EXERCISE IN CONJUNCTION WITHMUCSLE STIMULATOR VERSUS TRUNK TRAINING EXERCISE ALONE ON TRUNK BALANCE IN INDIVIDUALWITH SPINAL CORD INJURY

Recruiting

Conditions: Disease of spinal cord, unspecified,

Registration Number: CTRI/2021/04/032598

Lead Sponsor: Not Applicable

Brief Summary: AIM: Aim of the study is to evaluate the effect of goal oriented task specific training in conjunction with NMES in improving Trunk balance in individual with SCI. In people with SCI the changes in sensation, loss of muscle strength , and the presence of spasticity amongst other pathological changes can severely impair postural control and sitting balance leading to difficulties with most basic ADLâ€™s. Injuries of the spinal cord in the cervical and thoracic vertebral region lead to motor and/or sensory impairment of the trunk. Individuals with neurological SCI levels T10 to C1 have severely affected trunk control which has an impact on their sitting balance, and this could result in backward pelvis tilting and compromised seated posture. As a result, people with SCI use innervated, non-postural muscles (e.g., latisumus dorsi and pectoralis major) to compensate for the impairment, but their sitting balance still remains compromised. Moreover, during reaching tasks most individuals with SCI use one arm to maintain support by holding the wheelchair or by pivoting it on the lap for support . Other mechanical solutions for improving sitting balance include chest straps , seat cushions , foot rests and wheelchair adjustments but these solutions are limiting since they improve balance at the cost of reduced trunk mobility. Most SCI individual spend time in wheelchair therefore activities and balance training in sitting is important to improve the quality of life as well as rehabilitation program.

There are various methods for improving balance ability of SCI population. Recent rehabilitation program include balance training for SCI population using goal oriented task specific training. Goal oriented task specific training have been reported to be an effective method in that they increases the training amount and function and also arouses patient interest and attention by repeating task.

Another intervention NMES is a therapeutic modality in which muscle contraction is electrically stimulated in the area where surface electrodes are attached. It ameliorates Muscle atrophy and weakness secondary to immobilization and improves muscle strength via somatosensory stimulation that increases cortical excitability. Researchers have concluded that there is some suggestion that NMES increases voluntary strength in partially paralyzed muscle following SCI.

This study is designed to test the idea of comparing the effectiveness of 2 treatment protocol 1) Goal oriented task specific training 2) Goal oriented task specific training + NMES for subject with incomplete SCI.

The outcome measure will focus on trunk strength , balance and functional independence in sitting using MFRT, FIST and SCIM III version.

The total duration of intervention will be 3 weeks with a frequency of 5 times a week with each session of 30 min.

Paired and unpaired t-test will be used to evaluate the result.

Restoration of sitting balance is one of the goal of rehabilitation, however the effect of sitting balance training with NMES in conjunction with Goal oriented task specific training has not been specifically investigated. So the aim is to investigate the additive effects of combining two intervention on trunk balance in SCI patients.

Detailed Description: Not available

Recruitment & Eligibility

Status: Open to Recruitment

Sex: All

Target Recruitment: 20

Inclusion Criteria

1)Patient with SCI( traumatic/ non traumatic) 2)Participants with Age 18â€“60 years 3)Atleast 3 months prior to the study 4)ASIA grade B ,C and D SCI who are receiving physical and occupational therapy.
5)Â C5 or below neurological level.
6)Able to sit unsupported for at least 10â€‰seconds.
7)90 degree or more shoulder flexion.

Exclusion Criteria

1)Progressive non traumatic SCI.
2)Participants with cognitive impairment (inability to understand Instructions, Mini Mental State Examination score â©½ 24.
3)Orthopedic problems influencing unsupported sitting or Deformity of Upper extremity.
4)Pressure ulcers on the buttocks ,grade 3 & 4 or had pressure areas necessitating bed rest.
5)Cardiopulmonary insufficiency, cardiac pacemaker, Oncological disease, epilepsy, open wounds, or metal implants in the area where electrical stimulator is plan to be perform.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
1)Modified Functional Reach Test	(0 day - 3 weeks)
2) Function In Sitting Test(FIST)	(0 day - 3 weeks)

Secondary Outcome Measures

Name	Time	Method
1)SCIM III Version	(0 days - 3 weeks)

Trial Locations

Locations (1): ISIC institute of Rehabilitation Sciences
🇮🇳
South, DELHI, India
ISIC institute of Rehabilitation Sciences
🇮🇳South, DELHI, India
Archana Rawat
Principal investigator
7838024841
Rawat.19archana@gmail.com