Article

The efficacy of task-specific gait training for people
with spinal cord injury (SCI) is premised on evidence that the provision of
gait-related afferent feedback is key for the recovery of stepping movements.
Recent findings have shown that sensory feedback from flexor muscle afferents can
facilitate flexor muscle activity during the swing phase of walking. This case
report was undertaken to determine the feasibility of using robot-applied forces
to resist leg movements during body-weight-supported treadmill training (BWSTT)
and to measure its effect on gait and other health-related outcomes. CASE
DESCRIPTION: The patient described in this case report was a 43-year-old man with
a T11 incomplete chronic SCI. He underwent 36 sessions of BWSTT using a robotic
gait orthosis to provide forces that resist hip and knee flexion. OUTCOMES:
Tolerance to the training program was monitored using the Borg CR10 scale and
heart rate and blood pressure changes during each training session. Outcome
measures (ie, 10-Meter Walk Test, Six-Minute Walk Test, modified Emory Functional
Ambulation Profile [mEFAP], Activities-specific Balance Confidence Scale, and
Canadian Occupational Performance Measure) were completed and kinematic
parameters of gait, lower-extremity muscle strength (force-generating capacity),
lower-limb girth, and tolerance to orthostatic stress were measured before and
after the training program. DISCUSSION: The patient could tolerate the training.
Overground walking speed, endurance, and performance on all subtasks of the mEFAP
improved and were accompanied by increased lower-limb joint flexion and toe
clearance during gait. The patient's ambulatory self-confidence and
self-perceived performance in walking also improved. These findings suggest that
this new approach to BWSTT is a feasible and potentially effective therapy for
improving skilled overground walking performance.

Langue : ANGLAIS