Gait quality is improved by locomotor training in individuals with SCI regardless of training approach

Journal of NeuroEngineering and Rehabilitation, 2009 · DOI: 10.1186/1743-0003-6-36 · Published: October 2, 2009

Spinal Cord Injury Neurorehabilitation Biomechanics

Simple Explanation

This study compares different methods of locomotor training for people with spinal cord injuries. Locomotor training involves using body weight support systems while walking on a treadmill or overground. The goal was to see if one training method improved gait quality more than others. Gait quality was measured by looking at things like cadence, step length, and how symmetrical their steps were. The study found that all training methods improved gait quality, bringing it closer to that of people without disabilities. The method using a locomotor robot showed less improvement, possibly due to passive settings.

Study Duration

12 weeks

Participants

51 subjects with SCI, 10 non-disabled subjects

Evidence Level

Not specified

Key Findings

1
All BWSLT approaches improved gait quality in subjects with SCI, increasing cadence, step length, and stride length.
2
No significant differences were found among the training groups in terms of overall gait quality improvement.
3
Subjects in the overground with electrical stimulation (OG) and treadmill with electrical stimulation (TS) groups showed greater improvements in step and stride length compared to the locomotor robot (LR) group.

Research Summary

This study investigated the impact of four different BWSLT approaches on gait quality in individuals with chronic motor-incomplete SCI. The approaches included treadmill with manual assistance (TM), treadmill with electrical stimulation (TS), overground with electrical stimulation (OG), and treadmill with a locomotor robot (LR). The results indicated that all training approaches led to improvements in gait quality, as evidenced by increased cadence, step length, and stride length. However, there were no significant differences among the training groups, suggesting that all approaches are equally effective. Compared to non-disabled subjects walking at their preferred speed, those walking at a speed comparable to SCI subjects (with and without a walker) exhibited reduced gait quality, highlighting the influence of walking speed on gait parameters.

Practical Implications

Clinical Practice

Therapists can choose from various BWSLT approaches to improve gait quality in SCI patients.

Rehabilitation Strategies

Voluntary effort during training is important for improving motor skills related to gait quality.

Future Research

Further research is needed to determine optimal training parameters for robotic-assisted locomotor training.

Study Limitations

1
Large variability in outcome parameters among SCI subjects due to differences in the degree of injury.
2
Exclusion of a significant number of subjects from the analyses due to various reasons, including inability to achieve a kinematically identifiable step.
3
Assessment limited to locomotor training approaches using partial support for body weight.

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