A prediction model for determining over ground walking speed after locomotor training in persons with motor incomplete spinal cord injury.
OBJECTIVE
To develop and test a clinically relevant model for predicting the recovery of over ground walking speed after 36 sessions of progressive body weight-supported treadmill training (BWSTT) in individuals with motor incomplete spinal cord injury (SCI).


METHODS
A retrospective review and stepwise regression analysis of a SCI clinical outcomes data set.


METHODS
Outpatient SCI laboratory.


METHODS
Thirty individuals with a motor incomplete SCI who had participated in locomotor training with BWSTT. Eight individuals with similar diagnoses were used to prospectively test the prediction model.


METHODS
Over ground walking speed was assessed using the 10-m walking test.


METHODS
The locomotor training program consisted of 36 sessions of sequential comprehensive training comprised of robotic assisted BWSTT, followed by manual assisted BWSTT, and over ground walking. The dose of locomotor training was standardized throughout the protocol.


RESULTS
Clinical characteristics with predictive value for walking speed were time from injury onset, the presence or absence of voluntary bowel and bladder voiding, a functional spasticity assessment, and over ground walking speed before locomotor training. The model identified that these characteristics accounted for 78.3% of the variability in the actual final over ground walking speed after 36 sessions of locomotor training. The model was successful in prospectively predicting over ground walking speed in the 8 test participants within 4.15 +/- 2.22 cm/s in their recovered walking speed.


CONCLUSIONS
This prediction model can identify individuals who are most likely to experience success using locomotor training by determining an expected magnitude of training effect, thereby allowing individualized decisions regarding the use of this intensive approach to rehabilitation.
Winchester
Patricia
P
Department of Physical Therapy, University of Texas Southwestern Medical Center, 5223 Harry Hines Blvd, Dallas, TX 75390-8876, USA. patricia.winchester@utsouthwestern.edu
Smith
Patricia
P
Foreman
Nathan
N
Mosby
James M
JM
Pacheco
Fides
F
Querry
Ross
R
Tansey
Keith
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009069:Movement Disorders / Q000209:etiology* / Q000534:rehabilitation*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012044:Regression Analysis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000150:complications* / Q000534:rehabilitation; D016138:Walking / Q000502:physiology*; D016474:Weight-Bearing; D055815:Young Adult