scholarly journals A qualitative interview study on how people with incomplete spinal cord injury experience high-intensity walking exercise

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Malene Kolstad Sterling ◽  
Matthijs Ferdinand Wouda ◽  
Andreas Falck Lahelle

Abstract Study design Qualitative, in-depth research interviews. Objective To provide new insight into how people with a recent incomplete spinal cord injury (SCI) experience high-intensity walking exercise after discharge from subacute inpatient rehabilitation. Setting Informants for this interview study participated in a previous randomized controlled trial (RCT) that was conducted at Sunnaas Rehabilitation Hospital, Norway. Methods Four individual face-to-face interviews were conducted with the participants in natural setting. The interviews were analyzed through systematic text condensation and discussed in the context of experiences of bodily changes. Results Four themes emerged that described positive but also challenging bodily experiences related to performing high-intensity walking exercise: “Expectations and motivation”—reasons for participating, “Challenging bodily changes”—impacts on walking ability, “Adaptation strategies”—achieving the high-intensity target level, and “Integrating exercise into a new daily life”—combining participation, new body and new life. Conclusions This study indicates the importance of participating in a specific exercise program at discharge from subacute inpatient rehabilitation for ambulant people with SCI. However, high-intensity walking exercise may be too demanding to perform during this time period. The insights from the study provide new knowledge that can contribute to improving clinical rehabilitation practice.

2007 ◽  
Vol 87 (9) ◽  
pp. 1224-1232 ◽  
Author(s):  
Laura A Prosser

Background and Purpose: The outcomes of intense locomotor training after incomplete spinal cord injury (SCI) have been described in adults with acute and chronic injuries and with various levels of ambulatory function. This case report describes a comprehensive inpatient rehabilitation program with a locomotor training component in a child with a severe incomplete SCI.Case Description: A 5-year-old girl injured at C4 participated in locomotor training for 5 months during inpatient rehabilitation.Outcomes: The patient's Functional Independence Measure for Children II (WeeFIM II) mobility score increased from 5/35 to 21/35. Her Walking Index for Spinal Cord Injury II (WISCI II) score improved from 0 to 12. The patient returned to walking in the community with assistive devices.Discussion: It is feasible to include an intense locomotor training program in the clinical rehabilitation setting for a child with a severe SCI, and the outcomes were consistent with results in adults. Further investigation with experimental designs and more participants will determine the extent to which this intervention benefits the pediatric population with SCI.


2016 ◽  
Vol 96 (12) ◽  
pp. 1919-1929 ◽  
Author(s):  
Kristan A. Leech ◽  
Catherine R. Kinnaird ◽  
Carey L. Holleran ◽  
Jennifer Kahn ◽  
T. George Hornby

AbstractBackgroundHigh-intensity stepping practice may be a critical component to improve gait following motor incomplete spinal cord injury (iSCI). However, such practice is discouraged by traditional theories of rehabilitation that suggest high-intensity locomotor exercise degrades gait performance. Accordingly, such training is thought to reinforce abnormal movement patterns, although evidence to support this notion is limited.ObjectiveThe purposes of this study were: (1) to evaluate the effects of short-term manipulations in locomotor intensity on gait performance in people with iSCI and (2) to evaluate potential detrimental effects of high-intensity locomotor training on walking performance.DesignA single-day, repeated-measures, pretraining-posttraining study design was used.MethodsNineteen individuals with chronic iSCI performed a graded-intensity locomotor exercise task with simultaneous collection of lower extremity kinematic and electromyographic data. Measures of interest were compared across intensity levels of 33%, 67%, and 100% of peak gait speed. A subset of 9 individuals participated in 12 weeks of high-intensity locomotor training. Similar measurements were collected and compared between pretraining and posttraining evaluations.ResultsThe results indicate that short-term increases in intensity led to significant improvements in muscle activity, spatiotemporal metrics, and joint excursions, with selected improvements in measures of locomotor coordination. High-intensity locomotor training led to significant increases in peak gait speed (0.64–0.80 m/s), and spatiotemporal and kinematic metrics indicate a trend for improved coordination.LimitationsMeasures of gait performance were assessed during treadmill ambulation and not compared with a control group. Generalizability of these results to overground ambulation is unknown.ConclusionsHigh-intensity locomotor exercise and training does not degrade, but rather improves, locomotor function and quality in individuals with iSCI, which contrasts with traditional theories of motor dysfunction following neurologic injury.


2018 ◽  
Vol 42 (2) ◽  
pp. 94-101 ◽  
Author(s):  
Carey L. Holleran ◽  
Patrick W. Hennessey ◽  
Abigail L. Leddy ◽  
Gordhan B. Mahtani ◽  
Gabrielle Brazg ◽  
...  

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