Effect of Treadmill Training on Gait and Functional Independence in Patients with Incomplete Spinal Cord Injury: A Case Series

Background and purpose: Many individuals with an incomplete spinal cord injury (SCI) have the potential to walk. The effectiveness of using a treadmill for gait training for these patients has been substantiated in the literature. This case series describes the effectiveness of incorporating gait training on a treadmill for two individuals with an incomplete SCI. Case Description: The treatments of two males each with an incomplete paraplegia were described. Subject 1 was 40 years old and was 14 months post injury at the time of the study. He had a T6 incomplete spinal cord injury classified as a D on the American Spinal Injury Association (ASIA) Impairment Scale and neurological classification standards. Subject 2 was 48 years old and was 10 months post injury. He had a T8 incomplete spinal cord injury classified as ASIA C. Intervention: Both subjects participated in gait training for a maximum of 10 minutes on a motorized treadmill without elevation at a comfortable walking speed three days a week for four weeks as an adjunct to a conventional physiotherapy programme.Results: An increase in step length, stride length, cadence, and comfortable walking speed were noted in both subjects. Both subjects improved their walking level as measured by the Walking Index for Spinal Cord Injury (WISCI II) and functional independence as measured by Spinal Cord Independent Measure (SCIM II). Conclusion: Gait training on a treadmill can improve gait parameters and functional independence in patients with incomplete paraplegia. Further research is needed to improve the generalizability of these findings and to identify which patients might benefit most from treadmill training.

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Short Term Effects of Rhythmic Auditory Stimulation with Body Weight Supported Treadmill Training on Gait and Balance in Individuals with Incomplete Spinal Cord Injury

International Journal of Science and Healthcare Research ◽

10.52403/ijshr.20211027 ◽

2021 ◽

Vol 6 (4) ◽

pp. 191-197

Author(s):

Kanika Singhal ◽

Chitra Kataria

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Body Weight ◽

Gait Training ◽

Auditory Stimulation ◽

Treadmill Training ◽

Incomplete Spinal Cord Injury ◽

Cord Injury ◽

Rhythmic Auditory Stimulation ◽

Gait Trainer

Background: Rhythmic auditory stimulation and body weight supported treadmill training both are standardized gait rehabilitation techniques. However there is limited literature evaluating the effect of rhythmic auditory stimulation and its combination with gait training in spinal cord injury. Aim of this study is to determine the short term effectiveness of rhythmic auditory stimulation with body weight supported treadmill training on gait and balance in individuals with incomplete Spinal Cord Injury. Method: A randomized control study design. 8 subjects with incomplete spinal cord injury who met the inclusion criteria were randomly allocated into two groups: Experimental and Control. Subjects in experimental group were given body weight supported treadmill training with rhythmic auditory stimulation. Subjects in Control Group were given Body weight supported treadmill training alone. Both the groups received conventional rehabilitation as well. Both groups received training for 30 minutes, five times a week for two weeks (10 sessions). Outcome Measures: Gait parameters i.e. cadence, velocity, step length were measured using the Biodex Gait Trainer 2TM, level of walking performance measured using Walking Index for Spinal Cord Injury II, and balance was evaluated using Prokin 252NTM , Berg Balance Scale, and Activity specific Balance Confidence scale. Results: No significant improvement was found on gait parameters i.e. cadence, velocity, step length which were measured using the Gait Trainer, level of walking performance measured using WISCI II, and balance which was evaluated using Prokin 252NTM , Berg Balance Scale, and Activity specific Balance Confidence scale. Conclusion: Rhythmic auditory stimulation didn’t have any positive effect on gait training in incomplete spinal cord injured patients. Further studies are warranted to explore the entrainment effects of rhythmic auditory stimulation in spinal cord injured individuals on gait rehabilitation. Keywords: Rhythmic Auditory Stimulation (RAS), Body Weight Supported Treadmill Training (BWSTT), Metronome, Incomplete spinal cord injury, Biodex Gait Trainer 2.0, Prokin 252N

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Training of Walking Skills Overground and on the Treadmill: Case Series on Individuals With Incomplete Spinal Cord Injury

Physical Therapy ◽

10.2522/ptj.20080257 ◽

2009 ◽

Vol 89 (6) ◽

pp. 601-611 ◽

Cited By ~ 64

Author(s):

Kristin E. Musselman ◽

Karim Fouad ◽

John E. Misiaszek ◽

Jaynie F. Yang

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Small Group ◽

Walking Speed ◽

Skill Training ◽

Case Series ◽

Walk Test ◽

Incomplete Spinal Cord Injury ◽

Obstacle Clearance ◽

Cord Injury

Background and Purpose: Walking in the home and community is an important goal for individuals with incomplete spinal cord injury (iSCI). Walking in the community requires various skills, such as negotiating curbs, doors, and uneven terrain. This case report describes the use of a method to retrain walking overground that is intensive, variable, and relevant to daily walking (skill training). The aims of this case series were to determine the effectiveness of skill training in a small group of people with iSCI and to compare skill training with body-weight–supported treadmill training (BWSTT) in the same individuals.Case Description: Four individuals who were a median of 2.7 years (interquartile range [IQR]=12.8) after iSCI participated in alternating phases of intervention, each 3 months long. All patients started with BWSTT. Two patients subsequently engaged in skill training while the other 2 patients engaged in BWSTT, after which a third phase of intervention (opposite to the second) was repeated.Outcomes: The Modified Emory Functional Ambulation Profile, the 10-Meter Walk Test, the 6-Minute Walk Test, the Berg Balance Scale, and the Activities-specific Balance Confidence Scale were administered before training, monthly throughout training, and 3 months after training.Discussion: Overall improvements in walking speed met or exceeded the minimal clinically important difference for individuals with iSCI (≥0.05 m/s), particularly during the skill training phase (skill training: median=0.09 m/s, IQR=0.13; BWSTT: median=0.01 m/s, IQR=0.07). Walking endurance, obstacle clearance, and stair climbing also improved with both types of intervention. Three of the 4 patients had retained their gains at follow-up (retention of walking speed: median=92%, IQR=63%). Thus, the findings suggest that skill training was effective in this small group of individuals.

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