scholarly journals Walking Ability Outcome Measures in Individuals with Spinal Cord Injury: A Systematic Review

2021 ◽  
Vol 18 (18) ◽  
pp. 9517
Author(s):  
Isabel Sinovas-Alonso ◽  
Ángel Gil-Agudo ◽  
Roberto Cano-de-la-Cuerda ◽  
Antonio J. del-Ama
Keyword(s):  
Systematic Review ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Outcome Measures ◽  
Berg Balance Scale ◽  
Walking Ability ◽  
Walk Test ◽  
Timed Up And Go ◽  
Cord Injury ◽  
Profile Score

Walking function recovery in spinal cord injury (SCI) is tackled through several therapeutic approaches in which precise evaluation is essential. A systematic review was performed to provide an updated qualitative review of walking ability outcome measures in SCI and to analyze their psychometric properties. PubMed, Cochrane, and PEDro databases were consulted until 1 April 2020. Seventeen articles written in English were included. Five of them studied the walking index for SCI, four studied the 10 meter walk test, and two studied the six-minute walk test, the timed Up and go test, and the Berg balance scale. The rest of the articles studied the following metrics: gait profile score, spinal cord injury functional ambulation profile, five times sit-to-stand test, spinal cord injury functional ambulation inventory, spinal cord independence measure (indoors and outdoors mobility items), locomotor stages in spinal cord injury, community balance and mobility scale, and activity-based balance level evaluation scale. The choice of a single or a set of metrics should be determined by the clinician. Based on the results obtained in this review, a combination of outcome measures is proposed to assess walking ability. Future work is required to integrate a more realistic environment for walking assessment.

scholarly journals Effect of pelvic laparoscopic implantation of neuroprosthesis in spinal cord injured subjects: a 1-year prospective randomized controlled study

Spinal Cord ◽  
2021 ◽  
Author(s):  
Helge Kasch ◽  
Uffe Schou Løve ◽  
Anette Bach Jønsson ◽  
Kaare Eg Severinsen ◽  
Marc Possover ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Outcome Measures ◽  
Outcome Measure ◽  
Secondary Outcome ◽  
Controlled Study ◽  
Control Group ◽  
Walking Ability ◽  
Data Set ◽  
Cord Injury

Abstract Study design 1-year prospective RCT. Objective Examine the effect of implantable pulse generator and low-frequency stimulation of the pelvic nerves using laparoscopic implantation of neuroprosthesis (LION) compared with neuromuscular electrical stimulation (NMES) in SCI. Methods Inclusion criteria: traumatic spinal cord injury (SCI), age 18–55 years, neurological level-of-injury Th4–L1, time-since-injury >1 year, and AIS-grades A–B. Participants were randomized to (A) LION procedure or (B) control group receiving NMES. Primary outcome measure: Walking Index for Spinal Cord Injury (WISCI-II), which is a SCI specific outcome measure assessing ability to ambulate. Secondary outcome measures: Spinal Cord Independence Measure III (SCIM III), Patient Global Impression of Change (PGIC), Penn Spasm Frequency Scale (PSFS), severity of spasticity measured by Numeric Rating Scale (NRS-11); International Spinal Cord Injury data sets-Quality of Life Basic Data Set (QoLBDS), and Brief Pain Inventory (BPI). Results Seventeen SCI individuals, AIS grade A, neurological level ranging from Th4–L1, were randomized to the study. One individual was excluded prior to intervention. Eight participants (7 males) with a mean age (SD) of 35.5 (12.4) years were allocated to the LION procedure, 8 participants (7 males) with age of 38.8 (15.1) years were allocated to NMES. Significantly, 5 LION group participants gained 1 point on the WISCI II scale, (p < 0.013; Fisher´s exact test). WISCI II scale score did not change in controls. No significant changes were observed in the secondary outcome measures. Conclusion The LION procedure is a promising new treatment for individuals with SCI with significant one-year improvement in walking ability.

EFFECT OF LOWER EXTREMITY EXOSKELETON ROBOT IMPROVING WALKING FUNCTION AND ACTIVITY IN PATIENTS WITH COMPLETE SPINAL CORD INJURY

2019 ◽  
Vol 19 (08) ◽  
pp. 1940060
Author(s):  
XINGANG BAI ◽  
XIANG GOU ◽  
WENCHUN WANG ◽  
CHAO DONG ◽  
FANGXU QUE ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Adverse Events ◽  
Lower Extremity ◽  
Controlled Trial ◽  
Walking Ability ◽  
Walk Test ◽  
Exoskeleton Robot ◽  
Cord Injury ◽  
Complete Spinal Cord Injury

The objective of this research was to evaluate the effectiveness and safety of Lower Extremity Exoskeleton Robot improving walking function and activity in patients with complete spinal cord injury. A prospective, open and self-controlled trial was conducted which include eight patients with complete spinal cord injury accepted Lower Extremity Exoskeleton Robot training with Aider 1.0 and Aider 1.1 for 2 weeks. The 6[Formula: see text]min Walk Test (6MWT), 10[Formula: see text]m Walk Test (10 MWT), Hoffer walking ability rating, Lower Extremity Motor Score (LEMS), Spinal Cord Independence Motor (SCIM), Walking Index for Spinal Cord Injury Version II (WISCI II) were recorded before, 1 week and 2 weeks after training. During the training, the incidence of adverse events (AE), the incidence of serious adverse events (SAE), the incidence of device defects and other safety indicators were observed. Compared with the pre-training, indicators (6MWT, 10MWT, Hoffer walking ability rating, WISCI II) were significantly different after 1 week of training and after 2 weeks of training. Four adverse events occurred during the training period and the incidence of adverse events was 50%. And there was no SAE or device defects. Therefore, it is safe and effective to use the lower extremity exoskeleton robot to complete the walking ability of patients with complete spinal cord injury.

scholarly journals Effects of Robot-Assisted Gait Training in Individuals with Spinal Cord Injury: A Meta-analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-13 ◽  
Author(s):  
Chia-Ying Fang ◽  
Jia-Ling Tsai ◽  
Guo-Sheng Li ◽  
Angela Shin-Yu Lien ◽  
Ya-Ju Chang
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Lower Extremity ◽  
Gait Training ◽  
Controlled Trials ◽  
Walking Ability ◽  
Walk Test ◽  
Robot Assisted ◽  
Cord Injury ◽  
Ashworth Scale

Background. To investigate the effects of robot-assisted gait training (RAGT) on spasticity and pain in people with spinal cord injury (SCI). Material and methods. Four electronic databases (PubMed, Scopus, Medline, and Cochrane Central Register of Controlled Trials) were searched for studies published up to November 2019. Only human trials and of English language were included. The searched studies were reviewed and extracted independently by two authors. Randomized controlled trials (RCTs) and non-RCTs were pooled separately for analyses. Primary outcome measures included spasticity assessed by Ashworth scale (AS) or modified Ashworth scale (MAS) and pain assessed by VAS. Secondary outcome measures included lower extremity motor score (LEMS) and walking ability (i.e., 6-minute walk test, 10-meter walk test). Results. A total of 225 studies were identified. Eighteen studies (7 RCTs and 11 non-RCTs) including 301 subjects met inclusion criteria. The outcome measure of spasticity significantly improved in favor of RAGT group in non-RCTs (AS: 95%CI=−0.202 to -0.068, p≤0.001; MAS: 95%CI=−2.886 to -1.412, p≤0.001). The results on pain did not show significant change after RAGT in either RCTs or non-RCTs. LEMS and walking ability significantly increased in favor of RAGT. Conclusions. RAGT can improve spasticity and walking ability in people with SCI. The probable reason for no significant change in pain after RAGT is floor effect. RAGT is beneficial for normalizing muscle tone and for improving lower extremity function in people with SCI without causing extra pain.

scholarly journals Changes of Functional Ability in Patients With Spinal Cord Injury With and Without Falls During 6 Months After Discharge

2014 ◽  
Vol 94 (5) ◽  
pp. 675-681 ◽  
Author(s):  
Jirabhorn Wannapakhe ◽  
Preeda Arayawichanon ◽  
Jiamjit Saengsuwan ◽  
Sugalya Amatachaya
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Functional Ability ◽  
Fear Of Falling ◽  
Berg Balance Scale ◽  
Physical Activities ◽  
Functional Improvement ◽  
Walk Test ◽  
Cord Injury ◽  
Risk Of Falls

Background Ambulatory patients with spinal cord injury (SCI) encounter a high risk of falls. However, most of the fall data in the literature were subjectively reported, without evidence to confirm the functional ability of those with and without falls. Objectives The purpose of this study was to prospectively evaluate changes in functional ability relating to falls in participants with SCI who fell and those who did not fall during the 6-month period after discharge. Design A 6-month prospective design was used in the study. Method Fifty independent ambulatory participants with SCI were assessed for their functional ability using the Timed “Up & Go” Test, 10-Meter Walk Test, Berg Balance Scale, and Six-Minute Walk Test (6MWT) prior to discharge and 6 months afterward. After discharge, the participants' fall data were monitored monthly to categorize them into faller (≥1 fall in 6 months) and nonfaller (no fall) groups. Results Twenty-seven participants (54%) fell, and their baseline functional abilities were obviously lower than those who did not fall. After 6 months, the functional ability of these participants showed significant improvement for every test, whereas those who did not fall demonstrated a significant improvement only for the 6MWT. After adjusting for the baseline data, the functional ability at 6 months showed no significant differences between the groups. Limitations The study did not monitor physical activities of the participants during the follow-up period. The findings on fear of falling were subjectively reported by the participants. Conclusions Participants with SCI are commonly characterized as being active and enthusiastic, which may drive their physical activities. However, sensorimotor impairments following SCI hinder their ability to move safely, particularly in those with more functional deterioration. Therefore, greater functional improvement is accompanied by a higher risk of falls. Because falls can induce serious consequences, rehabilitation professionals may need to seek strategies to improve safety issues during movement for these patients, particularly in their own environments.

scholarly journals Acute Traumatic and Ischemic Spinal Cord Injuries Have a Comparable Course of Recovery

2020 ◽  
Vol 34 (8) ◽  
pp. 723-732
Author(s):  
Giorgio Scivoletto ◽  
Monica Torre ◽  
Alessia Mammone ◽  
Doris D. Maier ◽  
Norbert Weidner ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Functional Recovery ◽  
Spinal Cord Injuries ◽  
International Standards ◽  
Walking Ability ◽  
Walk Test ◽  
Severity Of Injury ◽  
Cord Injury ◽  
Matching Procedure

Background. The relative rarity of ischemic compared with traumatic spinal cord injury (SCI) has limited a comparison of the outcomes of these conditions. Objective. To investigate the neurological and functional recovery of ischemic compared with traumatic acute SCI. Methods. Data were derived from the European Multicenter Study Spinal Cord Injury database. Patients with ischemic (iSCI) or traumatic SCI (tSCI), aged 18 years or older were evaluated at different time points from incidence: at about 1 month, 3 months, and 6 months. The neurological status was assessed at each time point by the International Standards for Neurological Classification of Spinal Cord Injury and the functional status by the Spinal Cord Independence Measure. Walking ability was evaluated by Walking Index for Spinal Cord Injury, 10-Meter Walk Test, and 6-Minute Walk Test. Because of the imbalances of the 2 groups in respect to size and lesion severity, a matching procedure according to age, neurological level, and severity of injury was performed. Outcomes evaluation was performed by means of a 2-way repeated-measures ANOVA. Results. The matching procedure resulted in 191 pairs. Both groups significantly improved from about 15 days after the lesion to 6 months. No differences were found in the course of neurological and functional recovery of iSCI compared with tSCI. Conclusions. This analysis from a representative cohort of participants revealed that from 15 days following the cord damage onward, the outcomes after iSCI and tSCI are comparable. This finding supports the potential enrolment of patients with acute iSCI into clinical trials from that point in time after the event and an evaluation up to 6 months afterward.

scholarly journals Spinal cord injury and quality of life: a systematic review of outcome measures

2011 ◽  
Vol 2 (01) ◽  
pp. 37-44 ◽  
Author(s):  
Jefferson Wilson ◽  
Robin Hashimoto ◽  
Joseph Dettori ◽  
Michael Fehlings
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Outcome Measures ◽  
Cord Injury

scholarly journals The improvement of the Lower Limb exoskeletons on the gait of patients with spinal cord injury: A protocol for systematic review and meta-analysis

2021 ◽  
Author(s):  
Xinwei Yang ◽  
◽  
Huan Tu ◽  
Xiali Xue
Keyword(s):  
Systematic Review ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Lower Extremity ◽  
Meta Analysis ◽  
Lower Limbs ◽  
Walking Ability ◽  
Cord Injury ◽  
Review Question ◽  
Gait Function

Review question / Objective: The purpose of this systematic review and meta-analysis was to determine the efficacy of lower extremity exoskeletons in improving gait function in patients with spinal cord injury, compared with placebo or other treatments. Condition being studied: Spinal Cord Injury (SCI) is a severely disabling disease. In the process of SCI rehabilitation treatment, improving patients' walking ability, improving their self-care ability, and enhancing patients' self-esteem is an important aspect of their return to society, which can also reduce the cost of patients, so the rehabilitation of lower limbs is very important. The lower extremity exoskeleton robot is a bionic robot designed according to the principles of robotics, mechanism, bionics, control theory, communication technology, and information processing technology, which can be worn on the lower extremity of the human body and complete specific tasks under the user's control. The purpose of this study was to evaluate the effect of the lower extremity exoskeleton on the improvement of gait function in patients with spinal cord injury.

scholarly journals A Systematic Review of the Measurement Properties of Patient-Reported Outcome Measures in Spinal Cord Injury

2016 ◽  
Vol 6 (1_suppl) ◽  
pp. s-0036-1582941-s-0036-1582941 ◽  
Author(s):  
Aidin Abedi ◽  
Simin Seyedpour ◽  
Lidwine B. Mokkink ◽  
Farhad Shokraneh ◽  
Vafa Rahimi-Movaghar
Keyword(s):  
Systematic Review ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Measurement Properties ◽  
Cord Injury ◽  
Patient Reported

scholarly journals The Effectiveness and Safety of Exoskeletons as Assistive and Rehabilitation Devices in the Treatment of Neurologic Gait Disorders in Patients with Spinal Cord Injury: A Systematic Review

2016 ◽  
Vol 6 (8) ◽  
pp. 822-841 ◽  
Author(s):  
Christian Fisahn ◽  
Mirko Aach ◽  
Oliver Jansen ◽  
Marc Moisi ◽  
Angeli Mayadev ◽  
...  
Keyword(s):  
Systematic Review ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Lower Extremity ◽  
Assistive Device ◽  
Walk Test ◽  
Incomplete Spinal Cord Injury ◽  
Lower Extremity Function ◽  
Extremity Function ◽  
Cord Injury

Study Design Systematic review. Clinical Questions (1) When used as an assistive device, do wearable exoskeletons improve lower extremity function or gait compared with knee-ankle-foot orthoses (KAFOs) in patients with complete or incomplete spinal cord injury? (2) When used as a rehabilitation device, do wearable exoskeletons improve lower extremity function or gait compared with other rehabilitation strategies in patients with complete or incomplete spinal cord injury? (3) When used as an assistive or rehabilitation device, are wearable exoskeletons safe compared with KAFO for assistance or other rehabilitation strategies for rehabilitation in patients with complete or incomplete spinal cord injury? Methods PubMed, Cochrane, and Embase databases and reference lists of key articles were searched from database inception to May 2, 2016, to identify studies evaluating the effectiveness of wearable exoskeletons used as assistive or rehabilitative devices in patients with incomplete or complete spinal cord injury. Results No comparison studies were found evaluating exoskeletons as an assistive device. Nine comparison studies (11 publications) evaluated the use of exoskeletons as a rehabilitative device. The 10-meter walk test velocity and Spinal Cord Independence Measure scores showed no difference in change from baseline among patients undergoing exoskeleton training compared with various comparator therapies. The remaining primary outcome measures of 6-minute walk test distance and Walking Index for Spinal Cord Injury I and II and Functional Independence Measure–Locomotor scores showed mixed results, with some studies indicating no difference in change from baseline between exoskeleton training and comparator therapies, some indicating benefit of exoskeleton over comparator therapies, and some indicating benefit of comparator therapies over exoskeleton. Conclusion There is no data to compare locomotion assistance with exoskeleton versus conventional KAFOs. There is no consistent benefit from rehabilitation using an exoskeleton versus a variety of conventional methods in patients with chronic spinal cord injury. Trials comparing later-generation exoskeletons are needed.

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