A Home-Based Balance Exercise Training Program with Intermittent Visual Deprivation for Persons with Chronic Incomplete Spinal Cord Injury: A Pilot Study on Feasibility, Acceptability, and Preliminary Outcomes

Incomplete spinal cord injury (iSCI) results in impaired postural control and walking ability. Visual over-reliance may occur in iSCI individuals to maintain postural control. This can challenge their postural stability in various contexts of daily life activities. The present study assessed the feasibility, acceptability, and preliminary outcomes of balance training with intermittent visual deprivation using stroboscopic glasses on postural control and visual reliance during quiet standing in iSCI individuals. Training impact on walking performance was also evaluated. Seven chronic iSCI individuals participated in a 6-week home-based balance training program, three times weekly, using stroboscopic glasses. Postural and walking abilities were assessed pre- and post-training using a bipedal stance test (BST) and 10 m walking test (10 MWT). BST was performed, with open-eyes (OE) and closed-eyes (CE), on a force plate for three 30 s trials. The center of pressure (CoP) variables included were CoP area (A-CoP) and CoP mean velocity (MV-CoP). Romberg ratios (CE/OE) for two CoP variables were calculated. Duration and speed were measured in 10 MWT. Intervention feasibility was assessed using the feasibility and acceptability questionnaire. Data from able-bodied individuals were recorded and used as references of physiological performance. iSCI individuals were significantly less stable and showed visual over-reliance for postural steadiness compared to controls. Also, their walking ability was impaired. All iSCI individuals completed the training (adherence rate: 84%) and rated it highly feasible. A-CoP and MV-CoP significantly reduced after training in CE condition (p = 0.018, respectively) but not in OE condition (p > 0.05). The Romberg ratio of A-CoP was significantly lower (p = 0.018), but the Romberg ratio of MV-CoP was not (p > 0.05). A significant reduction in duration and increase in speed (p = 0.018, respectively) in performing the 10 MWT were observed. Preliminary findings from this explorative study indicated that 6-week home-based balance training with intermittent visual deprivation was feasible, acceptable, and had promising potential benefits in improving postural control with a reduction in visual over-reliance in iSCI individuals. The training enhanced also their walking performance.