Feasibility and impact of a Water Specific Therapy program in individuals with subacute incomplete spinal cord injury: A non-randomized controlled trial.

Abstract

Objectives: To study the feasibility of a Water Specific Therapy (WST) program in subjects with incomplete spinal cord injury (iSCI) and <6 months since injury. Secondary: To analyze the impact on balance and gait.

Design: Pilot study with single-subject repeated-measures.

Setting: Rehabilitation center.

Participants: Twelve individuals with subacute (≤6 months) motor iSCI (T1-L5).

Intervention: WST program comprising 18 sessions, 40-minute-long, including warm up, balance training, aerobic exercises, and cool-down, monitored via the Rating of Perceived Effort scale.

Outcome measures: Feasibility was assessed through adherence to treatment, safety and attrition rate. Self-perceived improvement (balance, gait, and lower limb strength) and difficulties encountered by physical therapists were also evaluated. Secondary outcomes included the Berg Balance Scale (BBS), Timed Up and Go test, 10-meter walk test (10-MWT), 6-minute walk test (6-MWT), and Walking Index for Spinal Cord Injury II (WISCI-II).

Results: Adherence to treatment reached 83%, with only two unrelated dropouts. No adverse effects were recorded, deeming the treatment safe. Self-perceived improvements were noted by 88.9% of subjects, with moderate and substantial gains in the three reported variables. Physiotherapists referred difficulties in reaching intensity targets, prompting program adaptations. Statistical significance (P < 0.05) was reached in BBS, 10-MWT, 6-MWT and WISCI-II outcomes.

Conclusion: WST is a feasible, safe, well-accepted method for treating subacute iSCI, potentially enhancing gait and balance in these subjects. Individualized program adaptations may be required. Controlled studies are warranted to determine it is effectiveness.Trial registration: ClinicalTrials.gov identifier: NCT03962218..