Locomotor Training Progression and Outcomes After Incomplete Spinal Cord Injury

Author:

Behrman Andrea L1,Lawless-Dixon Anna R2,Davis Sandra B3,Bowden Mark G4,Nair Preeti5,Phadke Chetan6,Hannold Elizabeth M7,Plummer Prudence8,Harkema Susan J9

Affiliation:

1. AL Behrman, PT, PhD, is Associate Professor, Department of Physical Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, Fla, and Research Investigator, VA Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, Fla.

2. AR Lawless-Dixon, PT, DPT, is Staff Physical Therapist, Shands at the University of Florida Medical Center, Gainesville, Fla

3. SB Davis, PT, is Research Physical Therapist, VA Brain Rehabilitation Research Center, Malcom Randall VA Medical Center

4. MG Bowden, MS, PT, is Research Physical Therapist, VA Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, and doctoral student, Rehabilitation Science Doctoral Program, University of Florida

5. P Nair, BPhT, is doctoral candidate, Rehabilitation Science Doctoral Program, University of Florida

6. C Phadke, PT, is doctoral candidate, Rehabilitation Science Doctoral Program, University of Florida

7. EM Hannold, PhD, is Research Health Scientist, Veterans Affairs Health Sciences Research and Development Service and VA Rehabilitation Research and Development Service, Rehabilitation Outcomes Research Center, Gainesville, Fla

8. P Plummer, PT, PhD, is NIDRR Postdoctoral Fellow, Brooks Center for Rehabilitation Studies, University of Florida, Jacksonville, Fla

9. SJ Harkema, PhD, is Associate Professor and Rehabilitation Research Director, Owsley B. Frazier Chair in Spinal Cord Rehabilitation, Department of Neurological Surgery, University of Louisville, and Frazier Rehab Institute, Louisville, Ky

Abstract

Abstract Background and Purpose. The use of locomotor training with a body-weight–support systemand treadmill (BWST) and manual assistance has increased in rehabilitation. The purpose of this case report isto describe the process for retraining walking in a person with an incomplete spinal cord injury (SCI) using the BWST and transferring skills from the BWST to overground assessment and community ambulation. Case Description. Following discharge from rehabilitation, a man with an incomplete SCI at C5–6 and an American Spinal Injury Association (ASIA) Impairment Scale classification of D participated in 45sessions of locomotor training. Outcomes. Walking speed and independence improved from 0.19 m/s as a home ambulator using a rolling walker and a right ankle-foot orthosis to 1.01 m/s as a full-time ambulator using a cane only for communitymobility. Walking activity (X̄±SD) per 24 hours increased from 1,054±543 steps to 3,924±1,629 steps. Discussion. In a person with an incomplete SCI, walking ability improved after locomotor trainingthat used a decision-making algorithm and progression across training environments.

Publisher

Oxford University Press (OUP)

Subject

Physical Therapy, Sports Therapy and Rehabilitation

Reference44 articles.

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