The safety and accuracy of home-based ballistic resistance training for people with neurological conditions.

In the past 5-10 years, there has been a growing number of studies implementing ballistic (i.e. fast) resistance training to improve walking. The aim of this study was to determine whether people with neurological conditions could perform ballistic exercises safely and accurately in their home environment. An observational study of 24 adults with a neurological condition (i.e. stroke, brain injury, multiple sclerosis, and neurosurgical) that limited mobility was carried out. Participants were supervised during seven ballistic exercises over six home-based sessions across three weeks. Safety was determined as the ability to perform the exercise independently. Accuracy was determined as the ability to perform the exercise on pre-determined criteria. The majority of participants had sustained a traumatic brain injury (n = 13) or stroke (n = 9) with a mean age of 38.3 (SD 15.3, range 17-68) years. The mean walking speed was 1.11 (SD 0.29, range 0.53-1.56) m/s. In terms of safety, participants performed the exercises safely 88% of the time, and accurately 49% of the time. Safe completion of each individual exercise ranged initially from 46% to 100% for participants, but accuracy was lower ranging from 17% to 58%. Threshold self-selected walking speeds for optimal sensitivity and specificity for safety ranged from 0.86 to 1.17 m/s and for accuracy ranged from 0.97 to 1.23 m/s. Most of the home-based ballistic resistance exercises were safe, but accuracy was low for several of the ballistic resistance exercises. Higher self-selected walking speeds were associated with more accurate performance.