Reach Us +44 7480022681

Slacklining to facilitate rehabilitation in Traumatic Brain Injury 2 years post injury: A case study for lower limb weakness and balance and clonus

Dr. C Philip Gabel, PhD. PT, MSc*

Denise Krklec Bond University Physiotherapy Clinical Educator, Australia

Corresponding Author:
Dr. C Philip Gabel
Bond University Physiotherapy Clinical Educator
PO Box 760 Coolum Beach 4573, Australia
Tel: 61 408 481125; Work: 61 7 5446 1022 AH: 61 7 5473 9614
E-mail: [email protected]
Visit for more related articles at Quality in Primary Care


Background: Slacklining, a complex neuromechanical composite-chain activity on a tightened band, uses whole-body dynamics to respond to external environmental changes. This enables self-developed response strategies for balance-retention through learning, neuroplastic changes and presynaptic downregulation of reflexes including Hoffman’s reflex. Composite chain activities hasten skill acquisition by providing challenges, uncommon in daily life or rehabilitation.

Methods: Case study examination of single and dual slacklining rehabilitation for a 42-year-old female, two years post traumatic brain injury (TBI) with affected balance, clonus, left-sided weakness, and fatigue (physical, cognitive, and psychosocial). Slacklining was introduced for 4-weeks (Figure 1) and effectiveness assessed through functional outcome status.

Results: Rehabilitation outcomes (Figure 2) included 2-month inpatient in a brain-injury rehabilitation unit (Pt#1- 2,ICU-wards); Outpatient rehabilitation 3-2xweekly over 16 months, followed by independent exercises and hydrotherapy (Pt#2-3); return to work commenced 1-year post-injury, gradually increasing from 4-18 hours over 12 months, with functional status unchanged (Pt#3-4). Increased work to 24-hours/week decreased hydrotherapy and exercises from fatigue and poor immunological status (Pt#4); remained working 24-hours/week, started slacklining 2-4xweek 10 minutes (Pt#5-baseline measure); after 3-weeks of slacklining function, balance and fatigue improved while clonus reduced (Pt#6). Status progressed with significant improvements in the ARGS, BESS and MFIS (student t-test, p<0.05)

Conclusions: These preliminary data indicate Slacklining has a notable effect on function post TBI. Slacklining as adjunct therapy to existing land/hydrotherapy exercises provides external stimulations that activate global-body responses and facilitate neuroplastic changes including pre-synaptic central down-regulation for some reflexes. This facilitated control, reduced neural fatigue and functional gains were quantifiable. Further research is required to determine therapy frequency and progression rates.

Select your language of interest to view the total content in your interested language

Viewing options

Flyer image
journal indexing image

Share This Article

agar io

rolex replica

wormax io