Effects of Overground Locomotor Training on Walking Performance in Chronic Cervical Motor-Incomplete Spinal Cord Injury: A Pilot Study

Publication date: Available online 11 December 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Jared M. Gollie, Andrew A. Guccione, Gino S. Panza, Peter Y. Jo, Jeffrey E. Herrick
ObjectiveTo determine the effects of a novel overground locomotor training (OLT) program on walking performance in people with chronic cervical motor-incomplete spinal cord injury (iSCI).DesignBefore-After Pilot Study.SettingHuman performance research laboratory.ParticipantsAdults (n=6; age>18 years) with chronic cervical iSCI C & D according to the American Spinal Injury Association Impairment Scale (AIS).InterventionOLT included two 90-minute sessions per week for 12-15 weeks. Training sessions alternated between uniplanar and multiplanar stepping patterns. Each session was comprised of five segments: joint mobility; volitional muscle activation; task-isolation; task-integration; activity rehearsal.Main Outcome MeasuresOverground walking speed, oxygen consumption (VO2), carbon dioxide production (VCO2).ResultsOLT increased overground walking speed (0.36±0.20 vs 0.51±0.24 m·s; P<0.001, d=0.68). Significant decreases in VO2 (6.6±1.3 vs 5.7±1.4 ml·kg·min; P=0.038, d=0.67) and VCO2 (753.1±125.5 vs 670.7±120.3 ml·min; P=0.036, d=0.67) during self-selected constant work-rate treadmill walking was also noted after training.ConclusionsOLT program used in this pilot study is feasible and improved both overground walking speed and walking economy in a small sample of people with chronic cervical iSCI. Future studies are necessary to establish the efficacy of this OLT program as well as to differentiate among potential mechanisms contributing to enhanced walking performance in people with iSCI following OLT.



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