Locomotor Training Approaches for Individuals with Spinal Cord Injury: A Preliminary Report of Walking‐related Outcomes

@article{FieldFote2005LocomotorTA,
  title={Locomotor Training Approaches for Individuals with Spinal Cord Injury: A Preliminary Report of Walking‐related Outcomes},
  author={Edelle C. Field-Fote and Stephen D Lindley and Andrew l. Sherman},
  journal={Journal of Neurologic Physical Therapy},
  year={2005},
  volume={29},
  pages={127–137}
}
Background and Purpose Body weight supported (BWS) locomotor training improves overground walking ability in individuals with motor-incomplete spinal cord injury (SCI). While there are various approaches available for locomotor training, there is no consensus regarding which of these is optimal. The purpose of this ongoing investigation is to compare outcomes associated with these different training approaches. Subjects and Methods Twenty-seven subjects with chronic motor-incomplete SCI have… 

Gait quality is improved by locomotor training in individuals with SCI regardless of training approach

BWSLT leads to improvements in gait quality (values closer to ND subjects) regardless of training approach, and it is hypothesized that the smaller changes in the LR group were due to the passive settings used for the robotic device.

Influence of a Locomotor Training Approach on Walking Speed and Distance in People With Chronic Spinal Cord Injury: A Randomized Clinical Trial

In people with chronic motor incomplete SCI, walking speed improved with both overgroundTraining and treadmill-based training; however, walking distance improved to a greater extent with overground training.

Dose-Response Outcomes Associated with Different Forms of Locomotor Training in Persons with Chronic Motor-Incomplete Spinal Cord Injury.

The findings suggest that greater distance achieved over the course of OG training is associated with better walking outcomes in the studied population of participants with chronic motor-incomplete spinal cord injury.

Comparison of training methods to improve walking in persons with chronic spinal cord injury: a randomized clinical trial

It is demonstrated that persons with chronic, motor-incomplete SCI can improve walking ability and psychological well-being following a concentrated period of ambulation therapy, regardless of training method.

Effect of Locomotor Training on Motor Recovery and Walking Ability in Patients with Incomplete Spinal Cord Injury: A Case Series

Gait training on a treadmill can enhance motor recovery and walking capabilities in subjects with incomplete SCI and an increase in lower extremity motor score and Walking capabilities at the end of training program was found.

Strength training versus robot-assisted gait training after incomplete spinal cord injury: a randomized pilot study in patients depending on walking assistance

In patients with chronic iSCI dependent on walking assistance, RAGT was not more effective in improving walking-related outcome compared to lower extremity strength training, however, the low sample size limits generalizability and precision of data interpretation.

Training of Walking Skills Overground and on the Treadmill: Case Series on Individuals With Incomplete Spinal Cord Injury

Overall improvements in walking speed met or exceeded the minimal clinically important difference for individuals with iSCI, and the findings suggest that skill training was effective in this small group of individuals.

Prediction of gait recovery in spinal cord injured individuals trained with robotic gait orthosis

It is found that the subject’s ankle torque can predict whether he/she would benefit most from Lokomat training prior to the therapy, and can help individualize therapeutic programs that maximize patient recovery while minimizing unnecessary efforts and costs.

Treadmill training after spinal cord injury

The trial demonstrates that aggressive rehabilitation in the early phase of SCI is likely to benefit a very high percentage of these individuals, and suggests that at least one h/day of weight-bearing standing and gait training should be emphasized as early as possible for up to 60 sessions, likely resulting in a progressive increase in walking speed over time.

Locomotor training with partial body weight support in spinal cord injury rehabilitation: literature review

The locomotor training with bodyweight support shows up, viable in the rehabilitation of patients who suffer from a neurological pathology such as the spinal cord injury.
...

References

SHOWING 1-10 OF 54 REFERENCES

Improved intralimb coordination in people with incomplete spinal cord injury following training with body weight support and electrical stimulation.

Results suggest that training may improve intralimb coordination in people with SCI following a 12-week program combining body weight support, electrical stimulation, and treadmill training.

Supported treadmill ambulation training after spinal cord injury: a pilot study.

This pilot study suggests that supported treadmill ambulation training can improve gait for individuals with incomplete SCIs by using objective gait measures.

Locomotor training after human spinal cord injury: a series of case studies.

Locomotor training using the response of the human spinal cord to sensory information related to locomotion to improve the potential recovery of walking after SCI is used.

Robotic-assisted, body-weight-supported treadmill training in individuals following motor incomplete spinal cord injury.

The use of robotic devices may assist physical therapists by providing task-specific practice of stepping in people following neurological injury by enhancing motor recovery and ambulation in 3 people following motor incomplete spinal cord injury.

Combined use of body weight support, functional electric stimulation, and treadmill training to improve walking ability in individuals with chronic incomplete spinal cord injury.

  • E. Field-Fote
  • Medicine
    Archives of physical medicine and rehabilitation
  • 2001
All subjects showed improvement in OGWS and overall LE strength, and further research is required to delineate the essential elements of these particular training strategies.

Step training with body weight support: effect of treadmill speed and practice paradigms on poststroke locomotor recovery.

Training at speeds comparable with normal walking velocity was more effective in improving SSV than training at speeds at or below the patient's typical overground walking velocity.

Partial body weight support with treadmill locomotion to improve gait after incomplete spinal cord injury: a single-subject experimental design.

Improvements in gait relative to speed, cadence, stride length, and percentages of stance and swing for both lower extremities during comfortable walking, fast walking, and running were studied in a subject with an incomplete C-5 on C-6 spinal cord injury.

Functional electrical stimulation-assisted walking for persons with incomplete spinal injuries: longitudinal changes in maximal overground walking speed.

It is concluded that the increased MOWS during walking training using the FES orthosis is mostly due to a therapeutic effect, implying that mechanisms of plasticity occur during such a training paradigm.
...