The effectiveness of balance re-education classes on balance impairments in individuals following acquired brain injury: a feasibility study

Journal Contribution ResearchOnline@JCU
Smith, M.;van Wijck, F.
Abstract

Background: Research is lacking into the efficacy of balance re-education for individuals with acquired brain injury (ABI). Greater specificity is required in terms of intervention, frequency and intensity to allow replication and comparison across studies and inform practice. Purpose: To explore the feasibility and effects of an 8-week balance re-education class for adults with ABI on balance, gait and function. Methods: Design: Pilot Randomised Controlled Trial (RCT). Interventions: Control group (n=5) received usual care physiotherapy; experimental group (n=7) received usual care physiotherapy plus an 8-week balance re-education circuit class. Outcomes: Berg Balance Scale (BBS), 10m Timed Walk, and the Timed Up and Go (TUG). Analysis: Between-group changes from baseline to after the intervention were compared using descriptive statistics and the Mann-Whitney U-test. Effect size was calculated using Cohen's d. Results: The experimental group improved more than the control group on the BBS (mean difference 1.6, 95% CI -5.5 to 8.8; p=0.74; d=0.3), Timed Walk duration (mean difference -6.5 s, 95% CI -12.8 to -0.2; p=0.03; d=1.1), and step count (mean difference -8.1 steps, 95% CI -11.4 to -4.8; p=0.004; d=1.7) and the TUG (mean difference -5.9 s, 95% CI -10.7 to -1.1; p=0.02; d=1.2). Conclusion: Preliminary findings suggested the intervention was feasible. Significant improvements with large effect sizes were found in the 10m Timed Walk and TUG. Improvements in balance (BBS) were of a moderate effect size but not significantly different from the control group. Implications: The programme can be successfully used within the clinical environment. Findings need to be viewed with caution as there was no placebo-control group. The study needs to be replicated in a powered RCT with long-term follow-up.

Journal

Physiotherapy

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Volume

101

ISBN/ISSN

1873-1465

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Issue

Supplement 1

Pages Count

1

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Publisher

Elsevier

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EISSN

N/A

DOI

10.1016/j.physio.2015.03.1363