Article

OBJECTIVE: To report the clinical improvements in spinal cord injury (SCI)
patients associated with intensive gait training using electromechanical systems
according to patient characteristics. DESIGN: Prospective longitudinal study.
SETTING: Inpatient SCI rehabilitation center. PARTICIPANTS: Adults with SCI
(n=130). INTERVENTION: Patients received locomotor training with 2 different
electromechanical devices, 5 days per week for 8 weeks. MAIN OUTCOME MEASURES:
Lower-extremity motor score, Walking Index for Spinal Cord Injury, and 10-meter
walking test data were collected at the baseline, midpoint, and end of the
program. Patients were stratified according to the American Spinal Injury
Association (ASIA) category, time since injury, and injury etiology. A subgroup
of traumatic ASIA grade C and D patients were compared with data obtained from
the European Multicenter Study about Human Spinal Cord Injury (EM-SCI). RESULTS:
One hundred and five patients completed the program. Significant gains in
lower-limb motor function and gait were observed for both types of
electromechanical device systems, to a similar degree. The greatest rate of
improvement was shown in the motor incomplete SCI patients, and for patients <6
months postinjury. The positive response associated with training was not
affected by injury etiology, age, sex, or lesion level. The trajectory of
improvement was significantly enhanced relative to patients receiving the
conventional standard of care without electromechanical systems (EM-SCI).
CONCLUSIONS: The use of electromechanical systems for intensive gait training in
SCI is associated with a marked improvement in lower-limb motor function and gait
across a diverse range of patients and is most evident in motor incomplete
patients, and for patients who begin the regimen early in the recovery process.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS