Article

OBJECTIVE: To model the progression of 3 functional outcome measures from
patients with incomplete spinal cord injury (SCI) receiving standardized
locomotor training. DESIGN: Observational cohort. SETTING: The NeuroRecovery
Network (NRN), a specialized network of treatment centers providing standardized,
activity-based therapy for SCI patients. PARTICIPANTS: Patients (N=337) with
incomplete SCI (grade C or D on the International Standards for Neurological
Classification of Spinal Cord Injury scale) who were enrolled in the NRN between
February 2008 and March 2011. INTERVENTION: All enrolled patients received
standardized locomotor training sessions, as established by NRN protocol, and
were evaluated monthly for progress. MAIN OUTCOME MEASURES: Berg Balance Scale,
6-minute walk test, and 10-meter walk test. Progression over time was analyzed
via the fitting of linear mixed effects models. RESULTS: There was significant
improvement on each outcome measure and significant attenuation of improvement
over time. Patients varied significantly across groups defined by recovery status
and American Spinal Injury Association Impairment Scale (AIS) grade at enrollment
with respect to baseline performance and rates of change over time. Time since
SCI was a significant determinant of the rate of recovery for all measures.
CONCLUSIONS: Locomotor training, as implemented in the NRN, results in
significant improvement in functional outcome measures as treatment sessions
accumulate. Variability in patterns of recovery over time suggest that time since
SCI and patient functional status at enrollment, as measured by the Neuromuscular
Recovery Scale, are important predictors of performance and recovery as measured
by the targeted outcome measures.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS