Acute (< 6 months) SCI
One good quality RCT examined the effect of an additional 3 weeks of task specific exercises on sitting balance in individuals with acute SCI following 6 weeks of standard inpatient rehabilitation consisting of practice of activities of daily living (N=32, AIS A=29, AIS B=2, AIS C=1) (Harvey et al., 2011). Participants were mainly motor complete paraplegics with a median time since injury of 11 weeks. Both experimental and control groups received 6 weeks of standard inpatient rehabilitation consisting of practice of activities of daily living. Despite receiving more training sessions, there was no additional benefit to the experimental group compared to the control group on functional outcomes of sitting balance.
Chronic (> 1 year) SCI
There were 5 studies that investigated the effects of various interventions (i.e. kayak ergometry, task specific exercises in unsupported sitting) on sitting balance. The majority of the participants had motor-complete SCI (N=76, AIS A=51, AIS B=23, AIS C=2). Sitting balance was significantly improved with kayak ergometer training in two Level 4 evidence trials with substantial transfer effects to functional tests in the wheelchair (Bjerkefors and Thorstensson, 2006; Bjerkefors et al., 2007). No significant effect was reported of 8 weeks open water kayak training vs. able-bodied control group who did not train (Grigorenko et al., 2004).
A good quality RCT assessed sitting balance in chronic SCI using the same task specific exercises as the study by Harvey et al (Harvey et al., 2011) in unsupported sitting for 6 weeks vs. a control group who received no training (N=30, AIS A=25, AIS B=15) (Boswell-Ruys et al., 2010). Overall improvements in both the training and control groups were reported. The addition of task-specific exercises using a rocker board to conventional physical therapy for 4 weeks yielded significant improvements in sit and reach tests as well as COP measures (N=12, AIS A=11, AIS B=1) (Kim et al. 2010). However, this was a relatively small study (N = 12) and it did not appear that participants were randomly assigned to the interventions.