Supported treadmill ambulation training after spinal cord injury: a pilot study.
OBJECTIVE
To conduct a pilot study of weight-supported ambulation training after incomplete spinal cord injury (SCI), and to assess its safety.


METHODS
Quasiexperimental, repeated measures, single group.


METHODS
Veterans Affairs medical center.


METHODS
Three subjects with incomplete, chronic, thoracic SCIs; 2 classified as D on the American Spinal Injury Association (ASIA) impairment scale and 1 as ASIA impairment scale C.


METHODS
Subjects participated in 12 weeks of training assisted by 2 physical therapists. The training consisted of walking on a treadmill while supported by a harness and a pneumatic suspension device. Support started at 40% of body weight and a treadmill speed of.16kmph, and progressed by reducing support and increasing treadmill speed and continuous treadmill walking time up to 20 minutes. Training was conducted for 1 hour per day, 5 days per week for 3 months. Treadmill walking occurred for 20 minutes during the sessions.


METHODS
Gait function (speed, endurance, walking status, use of assistive device and orthotics); oxygen costs of walking; brain motor control assessment; self-report indices; ASIA classification; muscle function test; and safety.


RESULTS
All 3 subjects increased gait speed (.118m/s initially to.318m/s after training 12wk), and gait endurance (20.3m/5min initially to 63.5m/5min). The oxygen costs decreased from 1.96 to 1.33mL x kg(-1) x m(-1) after 12 weeks of training.


CONCLUSIONS
This pilot study suggests that supported treadmill ambulation training can improve gait for individuals with incomplete SCIs by using objective gait measures. The self-report indices used have promise as patient-centered outcome measures of this new form of gait training. A larger, controlled study of this technique is warranted.
Protas
E J
EJ
School of Physical Therapy, Texas Woman's University, Houston 77030-2897, USA. hf_protas@twu.edu
Holmes
S A
SA
Qureshy
H
H
Johnson
A
A
Lee
D
D
Sherwood
A M
AM
D000203:Activities of Daily Living; D000328:Adult; D004576:Electromyography; D004734:Energy Metabolism; D005081:Exercise Therapy / Q000379:methods*; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011597:Psychomotor Performance; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D018709:Statistics, Nonparametric; D016138:Walking