Effect of unstable support surface core stability training on the rehabilitation of patients with thoracolumbar spinal fracture and incomplete spinal cord injury

Liang Junhao; Chen Luoxi; Liu Fulong; Liu Siyuan; Lai Huabing

doi:10.3760/j.issn.1673-4777.2024.10.017

Abstract：Objective To investigate the effect of unstable support surface core stability training(CST)on the rehabilitation of patients with thoracolumbar spinal fracture and incomplete spinal cord injury(ISCI).Methods A total of 96 patients with thoracolumbar spinal fracture with ISCI who underwent rehabilitation treat-ment in Sichuan Orthopedic Hospital from January 2019 to December 2022 were selected and divided into group A and group B by random number table method,with 48 cases in each group.Both groups received CST in sitting and recumbent positions.Group A was trained on an unstable support surface(training ball)and group B was trained on a stable support surface(training bed)for 8 weeks.The effects of improvement of American spinal injury association(ASIA)grading were evaluated before training and 10 weeks after training.Before training and 2,4,6,8 and 10 weeks after training,spinal cord independence measure(SCIM),functional independence measure(FIM)and walking index for spinal cord injury Ⅱ Scale(WISCI Ⅱ)scores were used to evaluate the recovery of spinal cord function in the two groups.The standing postural control ability and static balance ability of the two groups were evaluated,and the sagittal Cobb's angle of the injured vertebra was examined by X-ray film.Results At 10 weeks after training,the cases of grade B,C,and D in group A were 8,23 and 17,respectively,and those in group B were 11,30 and 7,respectively.The improvement of ASIA grading in group A was better than that in group B(P＜0.05).The SCIM,FIM and WISCI Ⅱ scores of group A were higher than those of group B at 4,6,8 and 10 weeks after training(all P＜0.05).The static eye opening trajectory length,static eye closing trajectory length,unit time trajectory length,dynamic stable trajectory length and dynamic time to reach the goal in group A were longer than those in group B(all P＜0.05).The Cobb's angle of group A was significantly smaller than that of group B at each time point(all P＜0.05).Conclusion The CST of unstable support surface can significantly improve the repair of spinal cord damage and walking function in patients with thoracolumbar spine fracture with ISCI.It can effectively promote the standing posture control ability of patients without the help of visual feedback.