Article

OBJECTIVE: To determine the effects of locomotor training on: (1) the International Standards for Neurological Classification of Spinal Cord Injury examination; (2) locomotion (gait speed, distance); (3) balance; and (4) functional gait speed stratifications after chronic incomplete spinal cord injury (SCI). DESIGN: Prospective observational cohort.
SETTING: Outpatient
rehabilitation centers in the NeuroRecovery Network (NRN). PARTICIPANTS:
Individuals (n=225) with American Spinal Injury Association Impairment Scale
(AIS) grade C or D chronic motor incomplete SCI having completed locomotor
training in the NRN. INTERVENTION: The NRN Locomotor Training Program consists of
manual-facilitated body weight-supported standing and stepping on a treadmill and
overground. MAIN OUTCOME MEASURES: AIS classification, lower extremity pin prick,
light touch and motor scores, ten-meter walk and six-minute walk tests, and the
Berg Balance Scale. RESULTS: Significant gains occurred in lower extremity motor
scores but not in sensory scores, and these were only weakly related to gait
speed and distance. Final Berg Balance Scale scores and initial lower extremity
motor scores were positively related. Although 70% of subjects showed
significantly improved gait speed after locomotor training, only 8% showed AIS
category conversion. CONCLUSIONS: Locomotor training improves gait speed to
levels sufficient for independent in-home or community ambulation after chronic
motor incomplete SCI. Changes in lower extremity motor and sensory scores do not
capture the full extent of functional recovery, nor predict responsiveness to
locomotor training. Functional classification based on gait speed may provide an
effective measure of treatment efficacy or functional improvement after
incomplete SCI.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS