| Influence of a locomotor training approach on walking speed and distance in people with chronic spinal cord injury: a randomized clinical trial. | |
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MedLine Citation:
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PMID: 21051593 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Edelle C Field-Fote; Kathryn E Roach |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural Date: 2010-11-04 |
Journal Detail:
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Title: Physical therapy Volume: 91 ISSN: 1538-6724 ISO Abbreviation: Phys Ther Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2011-01-03 Completed Date: 2011-02-02 Revised Date: 2011-08-01 |
Medline Journal Info:
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Nlm Unique ID: 0022623 Medline TA: Phys Ther Country: United States |
Other Details:
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Languages: eng Pagination: 48-60 Citation Subset: AIM; IM |
Affiliation:
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Department of Physical Therapy, Miller School of Medicine, University of Miami, Miami, Florida, USA. edee@miami.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Chronic Disease Exercise Test / methods Exercise Therapy / methods* Female Follow-Up Studies Humans Male Middle Aged Movement Disorders / etiology, rehabilitation* Physical Therapy Modalities Recovery of Function Robotics Severity of Illness Index* Single-Blind Method Spinal Cord Injuries / complications, rehabilitation* Statistics, Nonparametric Treatment Outcome Walking* Weight-Bearing Young Adult |
| Grant Support | |
ID/Acronym/Agency:
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R01HD41487/HD/NICHD NIH HHS |
| Comments/Corrections | |
Comment In:
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Phys Ther. 2011 Jan;91(1):60-2; author reply 62
[PMID:
21196560
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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