Locomotor Training and Muscle Function After Incomplete Spinal Cord Injury: Case Series

J Spinal Cord Med, 2008 · DOI: · Published: January 1, 2008

Spinal Cord Injury Physiology Rehabilitation

Simple Explanation

This study looked at whether locomotor training (LT) could help people with incomplete spinal cord injuries improve their muscle strength and size. Locomotor training involves repetitive practice of walking with body weight support. The study found that after nine weeks of LT, participants showed improvements in muscle strength, especially in their ankle muscles. Their muscles also got bigger, and they were better able to activate their muscles voluntarily. These findings suggest that LT can be a helpful therapy for people with incomplete spinal cord injuries to improve their muscle function and potentially their ability to walk.

Study Duration

9 weeks

Participants

5 individuals with chronic incomplete SCI

Evidence Level

Level 4; Longitudinal prospective case series

Key Findings

1
Locomotor training improved peak torque production in all participants, with the most significant increases in the plantar flexor muscles of the more-involved limb.
2
Indices of explosive torque, such as Torque200 and ARTD, also showed significant improvements after locomotor training, particularly in the plantar flexor muscles.
3
Improvements in torque production were associated with enhanced voluntary activation in both the knee extensor and ankle plantar flexor muscles and an increase in the maximal cross-sectional area of the ankle plantar flexor muscles.

Research Summary

This case series investigated the effects of 9 weeks of locomotor training (LT) on muscle strength, size, and activation in five individuals with chronic incomplete spinal cord injury (SCI). The study found that LT resulted in positive changes in both knee extensor (KE) and plantar flexor (PF) muscle groups, including increased muscle size (CSA), improved voluntary activation, and enhanced ability to generate peak and explosive torque. The improvements were more pronounced in the ankle PF muscles, highlighting their importance in locomotion and the potential benefits of LT for improving muscle function after incomplete SCI.

Practical Implications

Rehabilitation Strategy

Locomotor training should be considered as a rehabilitation strategy to improve lower extremity muscle function in individuals with incomplete SCI.

Targeted Muscle Training

Rehabilitation programs should prioritize training of the ankle plantar flexor muscles due to their critical role in locomotion and their responsiveness to locomotor training.

Assessment Tool Improvement

There is a need for more sensitive assessment tools to accurately measure neuromuscular recovery in chronic SCI patients, as traditional measures like ASIA scores may not capture subtle improvements.

Study Limitations

1
Small sample size (5 participants) limits the generalizability of the findings.
2
Lack of a randomized controlled design makes it difficult to rule out placebo effects.
3
The study did not directly relate the changes in strength to improvements in ambulation.

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