Ambulatory assistive devices and walking performance in patients with incomplete spinal cord injury

The majority of the people with incomplete spinal cord injury lose their walking ability, due to the weakness of their muscle motors in providing torque. As a result, developing assistive devices to improve their conditionis of great importance. In this study, a combined application of the saddle-assistive device (S-AD) and mechanical medial linkage or thosis was evaluated to improve the walking ability in patients with spinal cord injury in the gait laboratory. This mobile assistive device is called the saddle-assistive device equipped with medial linkage or thosis (S-ADEM). In this device, a mechanical orthosis was used in a wheeled walker as previously done in the literature. Initially, for evaluation of the proposed assistive device, the experimental results related to the forces and torques exerted on the feet and upper limbs of a person with the incomplete Spinal Cord Injury (SCI) during walking usingthe standard walker were compared with an those obtained from using the S-ADEM on an able-bodied subject. It was found that using this combination of assistive devices decreases the vertical force and torque on the foot at the time of walking by 53% and 48%, respectively compared to a standard walker. Moreover, the hand-reaction force on the upper limb was negligible instanding and walking positions usingthe introduced device. The findings of this study revealed that the walking ability of the patients with incomplete SCI was improved using the proposed device, which is due to the bodyweight support and the motion technology used in it.

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

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2016.10.022 ◽

2017 ◽

Vol 98 (6) ◽

pp. 1119-1125 ◽

Cited By ~ 6

Author(s):

Jared M. Gollie ◽

Andrew A. Guccione ◽

Gino S. Panza ◽

Peter Y. Jo ◽

Jeffrey E. Herrick

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Pilot Study ◽

Locomotor Training ◽

Incomplete Spinal Cord Injury ◽

Cord Injury ◽

Walking Performance

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High intensity body weight support treadmill training induces long-term walking performance improvement without spasticity increase after chronic incomplete spinal cord injury

Annals of Physical and Rehabilitation Medicine ◽

10.1016/j.rehab.2015.07.060 ◽

2015 ◽

Vol 58 ◽

pp. e23-e24

Author(s):

S. Mateo ◽

L. Arsenault ◽

L. Delporte ◽

A. Deleage ◽

T. Garnier ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Body Weight ◽

Performance Improvement ◽

Body Weight Support ◽

Incomplete Spinal Cord Injury ◽

Weight Support ◽

Cord Injury ◽

Walking Performance

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Daily acute intermittent hypoxia combined with walking practice enhances walking performance but not intralimb motor coordination in persons with chronic incomplete spinal cord injury

Experimental Neurology ◽

10.1016/j.expneurol.2021.113669 ◽

2021 ◽

pp. 113669

Author(s):

Andrew Q. Tan ◽

Won Joon Sohn ◽

Avantika Naidu ◽

Randy D. Trumbower

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Intermittent Hypoxia ◽

Motor Coordination ◽

Incomplete Spinal Cord Injury ◽

Cord Injury ◽

Walking Performance

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Daily Stepping in Individuals With Motor Incomplete Spinal Cord Injury

Physical Therapy ◽

10.2522/ptj.20090064 ◽

2010 ◽

Vol 90 (2) ◽

pp. 224-235 ◽

Cited By ~ 24

Author(s):

Poonam Saraf ◽

Miriam R. Rafferty ◽

Jennifer L. Moore ◽

Jennifer H. Kahn ◽

Kathryn Hendron ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Knee Extension ◽

Small Sample ◽

Substantial Contribution ◽

Activity Limitations ◽

Incomplete Spinal Cord Injury ◽

Knee Extension Strength ◽

Cord Injury ◽

Walking Performance

BackgroundIn individuals with motor incomplete spinal cord injury (SCI), ambulatory function determined in the clinical setting is related to specific measures of body structure and function and activity limitations, although few studies have quantified the relationship of these variables with daily stepping (steps/day).ObjectiveThe aim of this study was to quantify daily stepping in ambulatory individuals with SCI and its relationship with clinical walking performance measures and specific demographics, impairments, and activity limitations.DesignA cross-sectional study was performed to estimate relationships among clinical variables to daily stepping in self-identified community versus non–community (household) walkers.MethodsAverage daily stepping was determined in 50 people with chronic, motor incomplete SCI. Data for clinical and self-report measures of walking performance also were collected, and their associations with daily stepping were analyzed using correlation and receiver operating characteristic (ROC) analyses. Relationships between daily stepping and the measures of demographics, impairments, and activity limitations were identified using correlation and regression analyses.ResultsThe ROC analyses revealed a significant discriminative ability between self-reported community and non–community walkers using clinical gait measures and daily stepping. Stepping activity generally was low throughout the sample tested, however, with an average of approximately 2,600 steps/day. Knee extension strength (force-generating capacity) and static balance were the primary variables related to daily stepping, with metabolic efficiency and capacity and balance confidence contributing to a lesser extent.LimitationsThe small sample size and use of specific impairment-related measures were potential limitations of the study.ConclusionsDaily stepping is extremely limited in individuals with incomplete SCI, with a potentially substantial contribution of impairments in knee extension strength and balance.

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