Efficacy of Neurofeedback EEG training before virtual reality enhanced partial body weight supported treadmill training in improving neuropsychological status, balance and quality of life in incomplete spinal cord injury-A randomized clinical trial

The present study is a single-blinded, three-arm parallel-group randomized clinical trial which will include a total of 60 subjects diagnosed with incomplete spinal cord injury, (15% dropouts) will be selected based on inclusion criteria. The primary objective of the study is to evaluate the effectiveness of NF-EEG training before virtual reality enhanced partial body weight supported treadmill training and conventional physiotherapy in improving neuropsychological status, static & dynamic standing balance, walking index and quality of life in subjects with incomplete spinal cord injury. Before initiation of the study, subjects will be explained the purpose and procedure of the study. Thereafter written informed consent will be obtained from each subject and will undergo pre- intervention assessment by using Walking index for Spinal Cord Injury (WISCI)-II, Berg Balance Scale (BBS), Swaymeter, Beck Depression inventory and State-trait anxiety inventory, Modified Ashworth Scale (MAS), ASIA impairment scale and WHOQOL-BREF-participation. Afterwards, they will be randomly allocated into three groups: Group 1 (NF-EEG training prior to Virtual reality and conventional physiotherapy), Group 2 (NF- EEG training prior to conventional physiotherapy) and Group 3 (Conventional physiotherapy). Thereafter subjects of Group 1 (n=20) will undergo NF-EEG training prior to gait rehabilitation using virtual reality enhanced partial body weight supported treadmill training along with conventional physiotherapy. Whereas, Group 2 (n=20) will be treated with NF-EEG training prior to conventional physiotherapy. Subjects of Group 3 (n=20) will be treated with conventional physiotherapy only. Balance and Gait rehabilitation using virtual reality will be given for 30 minutes. Conventional physiotherapy protocol will also be followed for 40 minutes. The intervention will be given for three days a week on alternative days, for 12 weeks to all the subjects. After 12 weeks, post-intervention assessment will be done using same outcome measures as on first day.