Effectiveness of Task Oriented Physiotherapy in Improving Functional Mobility Among Patients with Incomplete Spinal Cord Injury: A Randomized Controlled Trial

Abstract

Background: Incomplete spinal cord injury (iSCI) frequently results in persistent deficits in gait, balance, and mobility despite preserved motor pathways, necessitating rehabilitation strategies that optimize neuroplasticity and functional recovery. Conventional physiotherapy primarily targets impairment-level strengthening, whereas task-oriented physiotherapy emphasizes repetitive, goal-directed functional activities that may better translate neurological gains into ambulatory independence. Objective: To compare the effectiveness of task-oriented physiotherapy versus conventional physiotherapy in improving functional mobility and motor recovery among adults with motor incomplete spinal cord injury. Methods: In this parallel-group randomized controlled trial, 22 adults aged 25–55 years with ASIA grades B–D were randomly allocated to receive either task-oriented physiotherapy or conventional physiotherapy three times weekly for four weeks. Primary outcome was functional ambulation measured by the Functional Ambulation Classification Scale (FACS); secondary outcome was neurological recovery assessed by ASIA motor score. Between- and within-group analyses were conducted using parametric and nonparametric tests with significance set at p<0.05. Results: The task-oriented group demonstrated significantly greater improvement in FACS (median change +2 levels vs +1; p=0.018) and ASIA motor score (mean increase 6.64 vs 2.45 points; p=0.023) compared with conventional therapy, with moderate-to-large effect sizes. Conclusion: Task-oriented physiotherapy yields superior short-term improvements in neurological motor function and ambulatory independence compared with conventional physiotherapy in adults with motor incomplete spinal cord injury, supporting its integration into standard rehabilitation practice.