Effectiveness of immersive virtual reality training to improve sitting balance control among individuals with acute and sub-acute paraplegia: A randomized clinical trial

Functional balance assessment for predicting future recurrent falls in non-ambulatory individuals with spinal cord injury: a prospective pilot study

BACKGROUND

Functional assessments easy to administer within the clinic to identify non-ambulatory individuals with spinal cord injury at risk of recurrent falls are needed.

PURPOSE

To examine the ability of functional balance and transfer quality to predict recurrent falls.

METHODS

This 6-month prospective study examined remote assessments of transfer quality using the Transfer Assessment Instrument and functional sitting balance with the Function in Sitting Test and the Trunk Control Test. Then, participants prospectively monitored their falls for 6-month using fall diaries. Frequency of falls was categorized as infrequent fallers (≤2 falls) and recurrent fallers (>2 falls). A multivariable logistic regression analysis was conducted. A Receiver Operating Characteristic curve was performed to determine the area under the curve, the sensitivity, and the specificity of the model.

RESULTS

Eighteen non-ambulatory individuals (mean age = 44 ± 16 years, mean time since injury = 7.8 ± 32.6 years) participated in the study. Poor balance (lower Function in Sitting Test score) was associated with higher odds of future recurrent falls (Odds Ratio = 0.70, 95% CI, 0.48 to 1.00, p = 0.05), area under the receiving operating curve = 0.87, sensitivity = 88%, and specificity = 70%.

CONCLUSIONS

A comprehensive sitting balance assessment that includes the static, proactive, and reactive components of balance with the integration of sensorial functions as evaluated within the Function in Sitting Test may be useful for predicting recurrent falls among non-ambulatory individuals with spinal cord injury. Replication of the findings in a larger sample is warranted.