Document Detail


Effectiveness of automated locomotor training in patients with chronic incomplete spinal cord injury: a multicenter trial.
MedLine Citation:
PMID:  15827916     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether automated locomotor training with a driven-gait orthosis (DGO) can increase functional mobility in people with chronic, motor incomplete spinal cord injury (SCI). DESIGN: Repeated assessment of the same patients or single-case experimental A-B design. SETTING: Research units of rehabilitation hospitals in Chicago; Heidelberg, Germany; and Basel and Zurich, Switzerland. PARTICIPANTS: Twenty patients with a chronic (>2 y postinjury), motor incomplete SCI, classified by the American Spinal Injury Association (ASIA) Impairment Scale with ASIA grades C (n=9) and D (n=11) injury. Most patients (n=16) were ambulatory before locomotor training. INTERVENTION: Locomotor training was provided using robotic-assisted, body-weight-supported treadmill training 3 to 5 times a week over 8 weeks. Single training sessions lasted up to 45 minutes of total walking time, with gait speed between .42 and .69 m/s and body-weight unloading as low as possible (mean +/- standard deviation, 37%+/-17%). MAIN OUTCOME MEASURES: Primary outcome measures included the 10-meter walk test, the 6-minute walk test, the Timed Up & Go test, and the Walking Index for Spinal Cord Injury-II tests. Secondary measures included lower-extremity motor scores and spastic motor behaviors to assess their potential contribution to changes in locomotor function. All subjects were tested before, during, and after training. RESULTS: Locomotor training using the DGO resulted in significant improvements in the subjects' gait velocity, endurance, and performance of functional tasks. There were no significant changes in the requirement of walking aids, orthoses, or external physical assistance. There was no correlation between improvements in walking speed or changes in muscle strength or spastic motor behaviors. CONCLUSIONS: Intensive locomotor training on a treadmill with the assistance of a DGO results in improved overground walking.
Authors:
Markus Wirz; David H Zemon; Ruediger Rupp; Anke Scheel; Gery Colombo; Volker Dietz; T George Hornby
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of physical medicine and rehabilitation     Volume:  86     ISSN:  0003-9993     ISO Abbreviation:  Arch Phys Med Rehabil     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-04-13     Completed Date:  2005-05-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  2985158R     Medline TA:  Arch Phys Med Rehabil     Country:  United States    
Other Details:
Languages:  eng     Pagination:  672-80     Citation Subset:  AIM; IM    
Affiliation:
Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Chronic Disease
Female
Gait
Humans
Male
Middle Aged
Orthotic Devices*
Robotics
Spinal Cord Injuries / rehabilitation*
Task Performance and Analysis
Treatment Outcome
Comments/Corrections
Comment In:
Arch Phys Med Rehabil. 2005 Dec;86(12):2385-6; author reply 2386-7   [PMID:  16344039 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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