The purpose of this study is to determine 1. if it is practical to treat moderately to severely brain injured patients who have problems with their balance and mobility in a group "boot camp" (3 days a week, 6 hours/day for 4 weeks) exercise class. 2. If they show improvements compared to 4 weeks of not receiving this treatment 3. If electronic daily monitoring of their center of foot pressure during a standardized balance task will allow us to see small changes in ability. A baseline assessment of all outcome measures will be performed. This will be repeated 4 weeks later. The intervention will be delivered (4 weeks) and a follow up assessment of all outcome measures will be performed one week later. A follow up of the Primary outcome measure, the PART-O participation questionnaire will be done 12 weeks later. Participants will attend group therapy consisting of a variety of exercises designed specifically to target balance and mobility deficits and based on the concept that through Repetitive Functional Task Practice (RFTP), recovery of function can occur as the result of neural adaptation. Exercises will be both individualized (delivered in a circuit) and group activities. Supervision and guidance will be provided by a registered Physical Therapist and a Rehabilitation Assistant. During the intervention, the amount and type of RFTP, any adverse events, and any need for extra staff will be recorded on a daily basis. As well, a standardized individualized task will be performed with center of foot pressure recording on a daily basis. Analysis: changes in outcome measures immediately after the non-intervention compared to the after the intervention period will be statistically determined to estimate efficacy of this treatment model. Descriptive measures of RFTP time/day, staffing levels/day and adverse events will be used to support feasibility and safety of this model.
See below for details about outcome measures and eligibility criteria.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
12
Intense physical rehabilitation directed at improving balance and mobility will be provided to individuals in a group setting (6 participants in a group) for 4 weeks, 3 days a week for 6 hours per day.
University of Manitoba, School of Medical Rehabilitation
Winnipeg, Manitoba, Canada
Change from baseline measure of Dual Task Cost of a visual cognitive task on stationery balance
The sway path length (SPL) will be recorded while standing unsupported. The performance on a visual spatial task will be recorded using a computer program that is based on the Useful Field of View test while the subject is in supported sitting. Then the balance task and cognitive task will be performed simultaneously to generate a Dual Task Cost in performance.
Time frame: This will be assessed 5 weeks prior, 1 week prior, 1 week post intervention
Change from baseline measure in time (seconds) to perform Five Times Sit to Stand Test
Time frame: 5 weeks, 1 week prior and 1 week post intervention
Change in score from baseline measure in Chedoke McMaster Stroke Assessment Activity Scale
A variety of functional mobility tasks including bed mobility, transfers, walking and stairs are performed and rated on a 7-point scale
Time frame: 5 weeks, 1 week prior and 1 week post intervention
Change from baseline measure of the Sway Path Length during The Modified Clinical Test of Integration in Balance (mCTSIB)
Ability to maintain still standing is assessed in 4 sensory conditions; on a solid surface eyes open, on a sponge surface eyes open, on a solid surface eyes closed and on a sponge surface eyes closed
Time frame: 5 weeks, 1 week prior and 1 week post intervention
Change in distance walked (meters) from baseline measure in the Two Minute Walk Test (2 MWT)
Time frame: 5 weeks, 1 week pre and 1 week post intervention.
Change in score from baseline measure in the Participation Assessment with Recombined Tools - Objective 17 (PART-O 17)
This is an interview-style questionnaire to quantify subject participation in the following domains; productivity, social relations and "out and about". It has been specifically developed for the brain injured population.
Time frame: This will be performed at the following time points: 5 weeks prior to the intervention, 1 week prior to the intervention, one week after the intervention and 12 weeks after the intervention
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