High-level mobility training benefits people with neurological impairment

Ms Tanja Spencer

A world-first study at the Monash Health Translation Precinct (MHTP) evaluating high-level mobility training in people with a neurological impairment has revealed the benefits of interventions.

Led by Monash Children’s Hospital physiotherapist Ms Tanja Spencer and Associate Professor Michael Fahey from Monash University’s Department of Paediatrics, the study was published last month in Brain Injury.

Neurological impairments such as acquired brain injury, spinal cord injury and cerebral palsy are a leading cause of disability worldwide.

Although many people with a neurological impairment can walk unaided, they still identify difficulty with high-level mobility skills.

“High-level mobility skills include activities beyond independent walking, such as running and jumping,” Ms Spencer said.

“Importantly, these skills facilitate participation in community life, sports and employment, and are therefore worthy of targeted intervention.”

Ms Spencer said the study is the very first systematic review to evaluate the emerging literature regarding high-level mobility interventions in people with a neurological impairment.

“Our findings provide evidence to support the role of various interventions in safely improving high-level mobility skills for a wide range of neurological diagnoses and participant ages,” Ms Spencer said.

Associate Professor Fahey said people with neurological impairment are often discharged from rehabilitation once they have achieved safe, independent ambulation and face challenges such as lack of funding for, and access to appropriate programs that address high-level mobility. 

“This study shows that clinicians can reasonably implement high-level mobility interventions in ambulant people with a neurological impairment, who have goals to do more than walk over level surfaces,” Associate Professor Fahey said. 

The research team is hopeful the systematic review will encourage physiotherapists to support their clients with a neurological impairment in pursuing their goals of returning to or improving their running, and sports participation. 

Ms Spencer has recently completed her Masters of Philosophy through Monash University’s Department of Paediatrics.

This research was initiated after a Running Group offered through the Victorian Paediatric Rehabilitation Service at Monash Children’s Hospital yielded positive results for children with neurological impairments.  An Emerging Researcher Fellowship from Monash Health allowed Tanja to finalise this systematic review and undertake a randomised controlled trial comparing the Running Group to usual care.  The results of that study have been widely presented at national and international childhood disability conferences and are currently being reviewed for publication.