Influence of a locomotor training approach on walking speed and distance in people with chronic spinal cord injury: a randomized clinical trial.
Phys Ther
; 91(1): 48-60, 2011 Jan.
Article
em En
| MEDLINE
| ID: mdl-21051593
ABSTRACT
BACKGROUND:
Impaired walking limits function after spinal cord injury (SCI), but training-related improvements are possible even in people with chronic motor incomplete SCI.OBJECTIVE:
The objective of this study was to compare changes in walking speed and distance associated with 4 locomotor training approaches.DESIGN:
This study was a single-blind, randomized clinical trial.SETTING:
This study was conducted in a rehabilitation research laboratory.PARTICIPANTS:
Participants were people with minimal walking function due to chronic SCI. INTERVENTION Participants (n=74) trained 5 days per week for 12 weeks with the following approaches treadmill-based training with manual assistance (TM), treadmill-based training with stimulation (TS), overground training with stimulation (OG), and treadmill-based training with robotic assistance (LR). MEASUREMENTS Overground walking speed and distance were the primary outcome measures.RESULTS:
In participants who completed the training (n=64), there were overall effects for speed (effect size index [d]=0.33) and distance (d=0.35). For speed, there were no significant between-group differences; however, distance gains were greatest with OG. Effect sizes for speed and distance were largest with OG (d=0.43 and d=0.40, respectively). Effect sizes for speed were the same for TM and TS (d=0.28); there was no effect for LR. The effect size for distance was greater with TS (d=0.16) than with TM or LR, for which there was no effect. Ten participants who improved with training were retested at least 6 months after training; walking speed at this time was slower than that at the conclusion of training but remained faster than before training.LIMITATIONS:
It is unknown whether the training dosage and the emphasis on training speed were optimal. Robotic training that requires active participation would likely yield different results.CONCLUSIONS:
In people with chronic motor incomplete SCI, walking speed improved with both overground training and treadmill-based training; however, walking distance improved to a greater extent with overground training.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Traumatismos da Medula Espinal
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Índice de Gravidade de Doença
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Caminhada
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Terapia por Exercício
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Transtornos dos Movimentos
Tipo de estudo:
Clinical_trials
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Etiology_studies
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Guideline
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Phys Ther
Ano de publicação:
2011
Tipo de documento:
Article
País de afiliação:
Estados Unidos