The effects of home-based arm training on trunk control following spinal cord injury: a pilot study

Alexander, Emma (2021). The effects of home-based arm training on trunk control following spinal cord injury: a pilot study. University of Birmingham. M.Sc.

Preview

Alexander2021MScbyRes_Redacted.pdf
Text - Redacted Version
Available under License All rights reserved.
Download (3MB) | Preview

Abstract

Abstract
Objective: This is a pilot and feasibility study to investigate the effects of a home-based arm cycling intervention on corticospinal excitability and neuromuscular control of trunk muscles in people with spinal cord injury (SCI).
Methods: Seven participants with chronic, incomplete cervical or thoracic SCI (mean age +/- SD: 57 +/- 15 years; cervical SCI; 5) undertook 30 minutes of arm cycling exercise at home, 5 consecutive days a week for six weeks. Assessments were performed before, during and after the exercise intervention. Corticospinal excitability was assessed using transcranial magnetic stimulation (TMS) eliciting motor evoked potentials (MEPs) in the erector spinae (ES) muscle. Trunk function was evaluated using multidirectional reaching, rapid shoulder flexion and perturbation tasks. Movement trajectory of the upper limbs and the trunk and the centre of pressure (COP) were recorded using a 3-D motion capture system and a force platform. Neuromuscular function of the ES muscles during the tasks was assessed using high-density electromyography (HDEMG). Three participants took part in a virtual focus group after completion of the study.
Results: Participants improved lateral reaching distance and reaction times with increased muscle activity during the rapid shoulder flexion task after the exercise intervention. This indicates improvement of voluntary control of the trunk after the intervention. A trend for increased amplitudes of ES MEPs was observed after the exercise intervention, suggesting arm exercise-induced neuroplasticity in corticospinal pathways projecting to the ES muscle. Furthermore, focus group data revealed that the intervention had both physical and psychological benefits to the participants.
Conclusions: Six weeks of home-based arm cycling intervention improved dynamic sitting balance (i.e. increased reaching distance) and neuromuscular function of the ES muscles in people with SCI. Our findings suggest this exercise programme to be feasible for trunk rehabilitation in patients with chronic, incomplete SCI.

Type of Work:

Thesis (Masters by Research > M.Sc.)

Award Type:

Masters by Research > M.Sc.

Supervisor(s):