Article

OBJECTIVE: To gain insight into who is likely to benefit from activity-based
therapy (ABT), as assessed by secondary analysis of data obtained from a clinical
trial. DESIGN: Secondary analysis of results from a randomized controlled trial
with delayed treatment design. SETTING: Outpatient program in a private,
nonprofit rehabilitation hospital. PARTICIPANTS: Volunteer sample of adults
(N=38; 27 men; 11 women; age, 22-63y) with chronic (>/=12mo postinjury),
motor-incomplete (American Spinal Injury Association [ASIA] Impairment Scale
[AIS] grade C or D) spinal cord injury (SCI). INTERVENTIONS: A total of 9h/wk of
ABT for 24 weeks including developmental sequencing; resistance training;
repetitive, patterned motor activity; and task-specific locomotor training.
Algorithms were used to guide group allocation, functional electrical stimulation
utilization, and locomotor training progression. MAIN OUTCOME MEASURES: Walking
speed and endurance (10-meter walk test and 6-minute walk test) and functional
ambulation (timed Up and Go test). RESULTS: This secondary analysis identified
likely responders to ABT on the basis of injury characteristics: AIS
classification, time since injury, and initial walking ability. Training effects
were the most clinically significant in AIS grade D participants with injuries <3
years in duration. This information, along with information about preliminary
responsiveness to therapy (gains after 12wk), can help predict the degree of
recovery likely from participation in an ABT program. CONCLUSIONS: ABT has the
potential to promote neurologic recovery and enhance walking ability in
individuals with chronic, motor-incomplete SCI. However, not everyone with goals
of walking recovery will benefit. Individuals with SCI should be advised of the
time, effort, and resources required to undertake ABT. Practitioners are
encouraged to use the findings from this trial to assist prospective participants
in establishing realistic expectations for recovery.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS