Adaptation of computerized posturography to assess seated balance in persons with spinal cord injury

Abstract

Background

The ability to retain or improve seated balance function after spinal cord injury (SCI) may mean the difference between independence and requiring assistance for basic activities of daily living. Compared with assessments of standing and walking balance, seated balance assessments remain relatively underemphasized and under-utilized.

Objective

To optimize tools for assessing seated balance deficits and recovery in SCI.

Design

Cross-sectional observational study of different methods for assessing seated balance function.

Setting

Veterans Affairs Center of Excellence for the Medical Consequences of Spinal Cord Injury.

Participants

Seven able-bodied volunteers, seven participants with chronic motor-complete thoracic SCI.

Interventions

A computerized pressure-plate apparatus designed for testing standing balance was adapted into a seated balance assessment system.

Outcome measures

Seated section of Berg Balance Scale; modified functional reach test; and two posturography tests: limits of stability and clinical test of sensory integration on balance.

Results

Seated posturography demonstrated improved correlation with neurological level of lesion compared to that of routinely applied subjective clinical tests.

Conclusion

Seated posturography represents an appealing outcome measure that may be applied toward the measurement of functional changes in response to various rehabilitation interventions in individuals with paralysis.

Keywords:

• Spinal cord injuries
• Paraplegia
• Rehabilitation
• Disability
• Assistive technology
• Berg balance scale
• Limits of stability
• Modified functional reach test
• Posturography

Acknowledgments

The authors wish to thank the VA Rehabilitation Research & Development (RR&D) Service, the RR&D National Center of Excellence for the Medical Consequences of Spinal Cord Injury (#B9212-C), the James J. Peters Veterans Affairs Medical Center (JJPVAMC), and the Mount Sinai School of Medicine Department of Neurology for providing research and salary support. We would also like to specifically thank Steven Knezevic for his assistance, and the Audiology Service, JJPVAMC, for generously providing us access to the Smart EquiTest apparatus.