None listed
Conditions
Brief summary
Background and purpose: Traumatic Brain Injury (TBI) is a leading cause of long-term disability and mortality, often resulting in mobility limitations. Associations exist between mobility limitations, poor community participation and reduced health-related quality of life within the TBI population. Ballistic Strength Training (BST) is a form of strength training aimed at improving muscle power generation. BST has shown to improve task-specific performance. Aim: This study aims to investigate the feasibility of implementing BST to improve mobility outcomes in People Recovering from Traumatic Brain Injury (PRFTBI), in an inpatient rehabilitation setting. Research design: The feasibility study will use a longitudinal experimental pretest-posttest design. Methods: Inpatients with first-ever moderate to severe TBI, less than six months post-injury, will be recruited. Participants will undergo BST as part of their physiotherapy management. A sample of convenience comprising of 27 PRFTBI will be used. Feasibility will be determined by collecting the following data: eligibility and uptake rate, adverse effects, intervention attendance, participant acceptability of BST using a Visual Analogue Scale (VAS), clinical feasibility by recording ability of participants to complete the exercises and participant perceived impression of change in walking ability using a Global Rating of Change (GRoC) scale. Preliminary effects of BST will be determined on the following mobility outcomes: self-selected walking speed using the 10-metre Walk Test (10mWT) and walking capacity using the 6-Minute Walk Test (6MWT). Descriptive statistics including means, standard deviations and percentages will be used to summarise the participant numbers and characteristics of the participants; and assess the feasibility measures and intervention outcome data at pre-test and post-test. Inferential statistics will be used to explain changes in feasibility and treatment effect outcome. Parametric or non-parametric inferential tests of comparison and correlation as appropriate will be performed at a 5% significance level. Significance of the study: This will be the first study to determine whether it is feasible to implement BST for improving mobility outcomes in the inpatient rehabilitation setting for PFRTBI. Should the intervention be found feasible, it will add to the body of knowledge of available treatment methods. The results of the study could inform a future randomised controlled trial.
Interventions
Ballistic Strength Training (BST) is a form of strength training aimed at improving muscle power generation also known as the rate of force production. BST is intentionally performed at high velocity with light loads and a focus on high repetition.
Participants will have two conventional physiotherapy sessions per week replaced by BST, for a maximum of four weeks (eight sessions). Each BST session will last approximately 30 minutes. Each BST session will be done at least 48 hours apart. Eac
Ballistic Strength Training (BST) is a form of strength training aimed at improving muscle power generation also known as the rate of force production. BST is intentionally performed at high velocity with light loads and a focus on high repetition. Participants will have two conventional physiotherapy sessions per week replaced by BST, for a maximum of four weeks (eight sessions). Each BST session will last approximately 30 minutes. Each BST session will be done at least 48 hours apart. Each BST session will be performed under direct supervision of physiotherapy team members in the physiotherapy gym at the inpatient rehabilitation centre. Exercise demonstrations and hands-on assistance will be provided to participants where necessary. Although all major lower limb muscle groups will be strengthened, it will target the three muscles groups critical for power generation during forward propulsion namely; the ankle plantar flexors during push-off in terminal stance, hip flexors at toe-off to accelerate the leg through swing phase and hip extensors at initial contact. The BST program will consist of two parts. Each part will consist of four exercises. Part A will consist of exercises performed below body weight on a reclined jump trainer. Part B will consist of body weight exercises, using equipment such as parallel bars and a mini-trampoline, with or without upper limb support and additional resistance. A BST exercise log will be kept per participant, by the researcher. The following will be recorded: ability to complete exercises (yes/no) and skills acquisition of the participants. Skills acquisition refers to the amount of assistance required (assistance/supervision/independent) as well as the appropriate speed required for the task of walking. The desired speed of movement is 60 beats per minute (using a metronome). The number of sessions attended, level of assistance required and reports of discomfort or adverse effects will be recorded for each BST session.
Sponsors
Izel Gilfillan
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* First-ever diagnosis of moderate to severe TBI. * Less than six months post-injury. * Age 18-65 years. * Independent, unaided baseline mobility (prior to TBI). * Able to walk with standby assistance of one therapist for greater than or equal to 14m. Assistive devices and orthoses permitted.
Exclusion criteria
* Unwilling or unable to obtain consent * Severe cognitive or behavioural problems that prevent assessment. * Medically unstable (preventing cardiovascular exercise) * Recent orthopaedic injuries restricting weight bearing or recent spinal surgery in the last six weeks. * Lower limb muscle weakness from peripheral cause * Previously diagnosed central nervous system disorder. * Walking is not the preferred mode of indoor mobility. * Independent, unaided with a self-selected walking speed of greater than 1.55m/s.
Outcome results
None listed