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The experiences of people with incomplete spinal cord injury or disease during intensive balance training and the impact of the program: A qualitative study


Study design

Qualitative descriptive study.


To gain insight into if and how participation in intensive balance training impacted the daily lives and risk of falling of people living with incomplete spinal cord injury or disease (SCI/D), as well as to understand what motivated participation and what benefits and challenges, if any, they experienced while completing training.


Tertiary rehabilitation hospital.


Semi-structured interviews were conducted three to four months after 20 participants with incomplete SCI/D completed either Perturbation-based Balance Training or Conventional Intensive Balance Training as part of a randomized clinical trial. Interviews were transcribed verbatim and coded using conventional content analysis by two researchers. Codes were discussed for consensus, and subcategories and categories were created, which were confirmed by another two researchers.


The following categories were identified: 1) goals of balance training, 2) valuable components of balance training, 3) physical gains from balance training, 4) psychosocial gains from participating in balance training, and 5) unique aspects of Perturbation-based Balance Training. Each category consisted of several subcategories.


Collecting qualitative data facilitated the evaluation of the meaningfulness of the balance training programs to the participants. These findings demonstrate that balance training was perceived as beneficial and enjoyable for individuals with incomplete SCI/D, and that these programs provided challenge and educational opportunities for the participants while improving balance confidence and reducing perceived fall risk. These findings have implications to direct future research studies or implementation of balance training in rehabilitation.

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Data availability

The datasets generated and/or analysed during the current study are not publicly available due to confidentiality of data, but are available from the corresponding author on reasonable request.


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The authors would like to thank Dr. Olinda Habib-Perez for assisting with translation of one interview.


Funding was provided by the Ontario Neurotrauma Foundation to KEM (grant 2016-RHI-PREV-1019). The funder played no role in the development of the study design, in the collection, analysis and interpretation of data, in the writing of the report, or in the decision to submit the article for publication.

Author information

Authors and Affiliations



JU contributed to study design, participant recruitment, data collection, data analysis, and drafting and revising the manuscript. HS contributed to study design, data collection, data analysis, and revising the manuscript. AV and KM contributed to data analysis and revising the manuscript. KEM contributed to study design, participant recruitment, data collection, data analysis, and drafting and revising the manuscript.

Corresponding author

Correspondence to Kristin E. Mussleman.

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Ethical approval

Ethical approval was obtained from the Research Ethics Board of the University Health Network (16-5685-DE). We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research.

Competing interests

The authors declare no competing interests.

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Unger, J., Singh, H., Mansfield, A. et al. The experiences of people with incomplete spinal cord injury or disease during intensive balance training and the impact of the program: A qualitative study. Spinal Cord (2022).

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