Article

In individuals with motor incomplete spinal cord injury (SCI),
ambulatory function determined in the clinical setting is related to specific
measures of body structure and function and activity limitations, although few
studies have quantified the relationship of these variables with daily stepping (steps/day). The aim of this study was to quantify daily stepping in
ambulatory individuals with SCI and its relationship with clinical walking
performance measures and specific demographics, impairments, and activity
limitations. DESIGN: A cross-sectional study was performed to estimate
relationships among clinical variables to daily stepping in self-identified
community versus non-community (household) walkers. METHODS: Average daily
stepping was determined in 50 people with chronic, motor incomplete SCI. Data for
clinical and self-report measures of walking performance also were collected, and
their associations with daily stepping were analyzed using correlation and
receiver operating characteristic (ROC) analyses. Relationships between daily
stepping and the measures of demographics, impairments, and activity limitations
were identified using correlation and regression analyses. RESULTS: The ROC
analyses revealed a significant discriminative ability between self-reported
community and non-community walkers using clinical gait measures and daily
stepping. Stepping activity generally was low throughout the sample tested,
however, with an average of approximately 2,600 steps/day. Knee extension
strength (force-generating capacity) and static balance were the primary
variables related to daily stepping, with metabolic efficiency and capacity and
balance confidence contributing to a lesser extent. LIMITATIONS: The small sample
size and use of specific impairment-related measures were potential limitations
of the study. CONCLUSIONS: Daily stepping is extremely limited in individuals
with incomplete SCI, with a potentially substantial contribution of impairments
in knee extension strength and balance.

Langue : ANGLAIS