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

STUDY DESIGN: A cross-sectional study. OBJECTIVES: To primarily explore types of ambulatory assistive device (AAD) used and secondarily describe walking performance in independent ambulatory patients with spinal cord injury (SCI) who walked without and with various AADs as determined using walking speed and distance walked in 6 min. SETTING: A tertiary rehabilitation center and community hospitals, Thailand. METHODS: The data of 195 independent ambulatory patients with SCI were used to describe the use of an AAD. Among these, only 140 subjects were assessed for their walking speed and distance walked in 6 min. RESULTS: More than half of the subjects (64%) walked with an AAD in which most of them used a standard walker (45%), followed by a single-tip cane (11%) and bilateral crutches (8%), respectively. The walking speed and distance showed significant differences among the groups (P<0.001), except those who used walker versus crutches, and those who used crutches versus cane (P>0.05). Among the significant variables, types of AAD used had the greatest influence on walking speed and distance of the subjects. CONCLUSION: More than half of ambulatory subjects with SCI walked with an AAD in which most of them used a standard walker. However, the non-significant differences of walking performance between the groups may suggest the heterogeneity of walking ability in subjects who used the same type of AAD. Therefore, a method to facilitate the use of an AAD with less supportive ability would increase levels of independence for the patients.

Concurrent validity of the 10-meter walk test as compared with the 6-minute walk test in patients with spinal cord injury at various levels of ability.

STUDY DESIGN: Cross-sectional design. OBJECTIVES: To evaluate the concurrent validity of the 10-meter walk test (10MWT) as compared with the 6-minute walk test (6MinWT) in patients with spinal cord injury (SCI) at various levels of walking ability, as determined using the criteria from the functional independence measure locomotor (FIM-L) scores. SETTING: A major tertiary referral hospital in Thailand. METHODS: Ninety-four independent ambulatory subjects with SCI (FIM-L scores 5-7) were assessed for their functional abilities using the 10MWT and 6MinWT. RESULTS: The data of the 10MWT and the 6MinWT had excellent correlation in subjects with FIM-L 7 (r=0.83, P<0.001), good correlation in subjects with FIM-L 6 (r=0.74, P<0.001), but poor correlation in subjects with FIM-L 5 (r=0.31, P>0.05). CONCLUSION: The 6MinWT is a thorough assessment to reflect functional endurance, but it requires a long time and a large area to administer. The findings confirm the utility of the 10MWT as an alternative monitoring tool to the 6MinWT, but only for the patients with rather good walking ability.