Influence of a Locomotor Training Approach on Walking Speed and Distance in People With Chronic Spinal Cord Injury: A Randomized Clinical Trial
By Field-Fote, Edelle C.; Roach, Kathryn E.; Physical Therapy (PTJ) , Volume 91, Number 1Publication Date: January 2011
Study compared changes in walking speed and distance associated with 4 locomotor training approaches in people with chronic motor incomplete spinal cord injury (SCI). Participants were 74 people with minimal walking function due to chronic SCI. Participants trained 5 days per week for 12 weeks with the following approaches: (1) treadmill based training with manual assistance (TM), (2) treadmill based training with bilateral stimulation to the common peroneal nerves (TS), (3) overground training with stimulation (OG), and (4) treadmill based training with assistance of the Lokomat robotic gait orthosis (LR). Primary outcome measures were overground walking speed and distance. In the 64 participants who completed the training, there were overall effects for speed and distance. For speed, there were no significant between-group differences; however, distance gains were greatest with OG. Effect sizes for speed and distance were largest with OG. Effect sizes for speed were the same for TM and TS. There was no effect for LR. The effect size for distance was greater with TS than with TM or LR, for which there was no effect. Ten participants who improved with training were retested at least 6 months after training, at which time walking speed was slower than that at the conclusion of training but remained faster than before training. Overall, findings indicate that gains in walking speed achieved with locomotor training in the overground environment are equivalent to the gains made with treadmill based training, and that the gains in walking distance achieved with overground training surpass those with treadmill based training.
Assistive Products Discussed: LOKOMATPRO (VERSIONS 5 & 6)
LOKOMATNANO
Published by: American Physical Therapy Association (Website:http://www.apta.org)
Link to text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3017322/?tool=pmcentrez
