Article

Walking speed is assumed to be a key factor in regaining ambulation
after spinal cord injury (SCI). However, from the literature it remains unclear
which walking speed usually results in independent community ambulation.
The primary aim of this study was to determine at which walking speed
SCI patients tend to walk in the community instead of using a wheelchair. The
secondary aim was to investigate clinical conditions that favor independent
ambulation in the community. METHODS: Data from SCI patients were collected
retrospectively from the European Multicenter Study about Spinal Cord Injury
database. We determined a cutoff walking speed at which the patients tend to walk
in the community by plotting a receiver operating characteristics curve, using
the Spinal Cord Independence Measure for outdoor mobility. Univariate analyses
investigated which factors influence independent community ambulation. RESULTS: A
walking speed of 0.59 m/s is the cutoff between patients who do and do not
ambulate independently in the community, with a sensitivity of 91.6% and a
specificity of 80.3%. Age, injury severity, and lower limb muscle strength have a
significant influence on independent community ambulation.
CONCLUSIONS: Patients
with an SCI who regain a walking speed of 0.59 m/s tend to achieve a level of
walking effectiveness that allows for independent community walking. Although
such patients tend to be younger and less severely injured, this walking speed
can be a target for locomotor training in rehabilitation and clinical trials that
lead to a meaningful outcome level of community walking.

Langue : ANGLAIS