Vol. 49 - No. 3 EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE 353 Balance training improves static stability and gait in chronic incomplete spinal cord injury subjects: a pilot study strated by clinical and instrumental evaluation; the improvement was maintained at follow-up examina- tions. Further, in the EXP group, the enhancement in balance that existed at T1 preceded the improve- ment in gait, and signiicant correlations between the improvements in gait and balance were observed. In comparison with H data, vBFB treatment demonstrat- ed a signiicant higher level of effectiveness than con- ventional Rehab. Conclusion. vBFB training is effective in improving balance and gait in chronic SCI subjects. Clinical Rehabilitation Impact. Inclusion of vBFB in rehabilitation protocols for chronic SCI subjects ef- fects greater improvements in gait than conventional rehabilitation alone. KEY WORDS: Spinal cord injuries - Biofeedback, phsycology - Postural balance - Gait. E pidemiological studies have shown that approxi- mately 50% of patients with traumatic spinal cord damage suffer an incomplete lesion (e.g., with sensory and motor preservation below the level of the lesion). 1 Depending on the severity of the lesion, most patients have the potential to recover walking function. 2 Further, walking recovery is one of the principal goals after a spinal cord injury (SCI) and is considered the most important objective by patients with incomplete lesions. 3 Thus, recovery of ambu- lation is the target of several pharmacological and rehabilitative approaches. 4-6 Spinal Cord Unit, IRCCS Santa Lucia Foundation Rome, Italy EUR J PHYS REHABIL MED 2013;49:353-64 F. TAMBURELLA, G. SCIVOLETTO, M. MOLINARI Background. Walking is considered the most impor- tant goal after an incomplete spinal cord injury (SCI). Only recently it has been demonstrated that balance is a key factor of walking recovery, but no data on the eficacy of balance training in supporting walking function in SCI subjects are available. Aim. The object of the study was to determine the eficacy of visual biofeedback task-speciic balance training (vBFB) in improving balance performance and gait in SCI subjects compared with conventional over-ground rehabilitation (Rehab). Design. Open-case study with retrospective matched control. Setting. Chronic SCI outpatients and healthy subjects (H). Population. Twelve SCI subjects with ASIA impair- ment scale grade D-6 in the vBFB group (EXP) and 6 in the Rehab group (CTRL)-and 6 H. Methods. Data from H were used as reference for phys- iological balance and gait parameters. CTRL and EXP groups underwent 8 weeks of rehabilitation 5 times/ week (CTRL group: 60 minutes devoted to Rehab; EXP group: 40 minutes of Rehab plus 20 of vBFB). At base- line (T0), every 10 vBFB sessions (T1-T2-T3), at the end of training (T4) and 1 and 2 months after vBFB was halted, data on the following parameters were collected and compared between groups and training steps: Berg Balance Scale, Walking Index for Spinal Cord Injury, 6-minute walking, 10-meter walk and timed up and go tests, balance performance (assessed with a stabilometric platform), and kinematic spatio- temporal gait parameters (collected using a 2-dimen- sional motion analysis system). Results. At T4, only the EXP group experienced a signiicant improvement in balance and gait demon- Corresponding author:F. Tamburella, Spinal Cord Unit - IRCCS S. Lucia Foundation, via Ardeatina 306, 00179 Rome, Italy. E-mail: f.tamburella@hsantalucia.it MINERVA MEDICA COPYRIGHT® This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher.