[Purpose] This study aimed to compare changes in the center of pressure between healthy subjects and patients with spinal cord injury and to provide basic information to these patients for improving their sitting balance. [Subjects and Methods] A total of 12 healthy subjects without histories of neurological or psychiatric disorders and 12 patients with spinal cord injuries were recruited. In all subjects, a change in the center of pressure during the performance of the modified functional reach test was measured using a Force Sensing Array system while the subjects were seated in a wheelchair. In the spinal cord injury group, the change in the center of pressure was highest when subjects reached forward while holding a gym ball. [Results] In the spinal cord injury group, the change in the center of pressure was highest when subjects reached forward while holding a gym ball. A significant correlation between forward reaching of the upper limbs with shoulders at 90° flexion and a change in the center of pressure was found. [Conclusion] Our findings suggest that the combination of functional reaching and the change in the center of pressure assessment is novel enough to be attempted to achieve sitting balance control in patients with spinal cord injury. The findings can provide clinical interventions that contribute to the improvement in the balance ability of wheelchair-dependent individuals.

Effects of anterior weight-shifting methods on sitting balance in wheelchair-dependent patients with spinal cord injury.

Purpose: This study was examined the effect of training using a Virtual Reality System on the sitting balance and Activities of Daily Living for patients with a spinal cord injury. Methods: The subjects were divided into an experimental (6 persons) and control group (5 persons). The experimental group trained the 5 programs, three times per week for 6 weeks using the Virtual Reality System and five days for week using conventional physical therapy. The control group trained five days for a week using conventional physical therapy. Results: The difference in the mean Spinal Cord Independence Measurement (SCIM) score in the experimental and control groups was increased to 8.33 and 6.60 (p=0.79), respectively. The difference in the mean functional reaching test in experimental and control group increased to 4.21 and 1.09 (p=0.25), respectively. The difference in the mean sitting time in experimental and control group increased to 41.05 and 10.33 (p=0.66), respectively. There was a difference in the mean of all variances but these differences were not statistically significant. Conclusion: These results suggest that training using the Virtual Reality System increased the SCIM, functional reaching test and sitting time in people with a spinal cord injury.

The Effect of Training Using Virtual Reality System on Sitting Balance and Activities of Daily Living for the Patient with Spinal Cord Injury

Objective: To systematically review the research studies that reported reliability of modified functional reach test for the assessment of sitting balance function in people with spinal cord injury.
Methods: A systematic review was conducted according to PRISMA guidelines. Research studies published in English language from the earliest record to October 2019 that reported any type of reliability of modified functional reach test in assessing balance function in adult SCI population were included. Those studies were excluded which reported correlation of modified functional reach test with other outcome measures and not explicitly reported reliability of the modified functional reach test. Reviews, commentaries, letter to editors, conference papers and short communications were also excluded.
Results: Initially, 108 research articles were retrieved from different databases, however after duplicate removal and applying inclusion/exclusion criteria, only 6 research studies were included in current systematic review. All 6 studies reported only test-retest reliability of modified functional reach test. Four studies measured only forward reach while remaining 2 studies measured reach in different directions. All 6 studies reported good to excellent reliability of modified functional reach test with interclass coefficient values ranging from 0.78 to 0.99.
Conclusion: Modified functional reach test is a reliable tool for assessing sitting balance function in individuals with SCI.
Continuous...

Reliability of modified functional reach test in the assessment of balance function in people with spinal cord injury: A systematic review.

In general, sitting balance is decreased in subjects with spinal cord injury. The purpose of this study was to evaluate the inter- and intra-rater reliability of the Functional Reach Test (FRT) which is used to measure sitting balance. The subjects of this study were 26 persons with spinal cord injury, and they were divided into three groups according to their injury level. Group I, II and III consisted of the following quadriplegics, , and paraplegics, respectively. Subjects sat on a mat table that was set at an 80 degree inclination. During three sessions, the length subjects could reach in the FRT test was measured by three physical therapists, and compared to each other. The results showed that intraclass correlation coefficients (2,1) were above 0.97 and inter-rater difference was not statistically significant. The one-way ANOVA demonstrated that reach differed between groups with lower thoracic lesion and the other test groups. In conclusion, we think modified FRT is useful and reliable method to measure the sitting balance in subjects with spinal cord injury.

Won-Kyu Min

Papers

The Inter- and Intra-rater Reliability of the Functional Reach Test in Subjects With Spinal Cord Injury