Article

High-intensity stepping practice may be a critical component to
improve gait following motor incomplete spinal cord injury (iSCI). However, such
practice is discouraged by traditional theories of rehabilitation that suggest
high-intensity locomotor exercise degrades gait performance. Accordingly, such
training is thought to reinforce abnormal movement patterns, although evidence to
support this notion is limited.
The purposes of this study were: (1) to evaluate the effects of short-term manipulations in locomotor intensity on
gait performance in people with iSCI and (2) to evaluate potential detrimental
effects of high-intensity locomotor training on walking performance. DESIGN: A
single-day, repeated-measures, pretraining-posttraining study design was used.
METHODS: Nineteen individuals with chronic iSCI performed a graded-intensity
locomotor exercise task with simultaneous collection of lower extremity kinematic
and electromyographic data. Measures of interest were compared across intensity
levels of 33%, 67%, and 100% of peak gait speed. A subset of 9 individuals
participated in 12 weeks of high-intensity locomotor training. Similar
measurements were collected and compared between pretraining and posttraining
evaluations. RESULTS: The results indicate that short-term increases in intensity
led to significant improvements in muscle activity, spatiotemporal metrics, and
joint excursions, with selected improvements in measures of locomotor
coordination. High-intensity locomotor training led to significant increases in
peak gait speed (0.64-0.80 m/s), and spatiotemporal and kinematic metrics
indicate a trend for improved coordination. LIMITATIONS: Measures of gait
performance were assessed during treadmill ambulation and not compared with a
control group. Generalizability of these results to overground ambulation is
unknown. CONCLUSIONS: High-intensity locomotor exercise and training does not
degrade, but rather improves, locomotor function and quality in individuals with
iSCI, which contrasts with traditional theories of motor dysfunction following
neurologic injury.
CI - (c) 2016 American Physical Therapy Association.

Langue : ANGLAIS