Restoration of walking function in an individual with chronic complete (AIS A) spinal cord injury.
OBJECTIVE
The prognosis for further recovery of motor function 2 years after complete spinal cord injury is poor. This case report describes recovery of walking function in an a 33-year old man two years post T7 spinal cord injury American Spinal Injury Association Impairment Scale A following intensive physical therapy and robotic locomotor training.


METHODS
Case report.


METHODS
The subject engaged in an intensive clinic-based physical therapy program and research-based robotic locomotor training study over a 7-month period. Physical therapy was initiated 4 months prior to entry into the research study, and targeted trunk control, upper extremity strength, and upright mobility. On initial entry into the robotic locomotor training study the subject's AIS A classification was substantiated. Initial, interim, and follow-up tests of sensation, strength, sitting balance, spasticity, and mobility were performed.


RESULTS
Lower extremity motor scores improved from 0/50 to 4/50, bilateral hip flexors increased from grade 0/5 to 2/5, warranting injury re-classification from American Spinal Injury Association Impairment Scale A to C. Intensive physical therapy combined with robotic locomotor training was associated with restoration of short distance walking function with lower extremity braces and a walker.


CONCLUSIONS
To our knowledge, this is the first report of an individual with chronic spinal cord injury American Spinal Injury Association Impairment Scale A improving in over-ground walking ability following intensive physical therapy and robotic locomotor training. The presence of a neurophysiologically discomplete lesion probably permitted training of operational neural pathways and enabled the development of useful voluntary movement.
Manella
Kathleen J
KJ
Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, Florida, USA.
Torres
Juana
J
Field-Fote
Edelle C
EC
D000328:Adult; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology; D008297:Male; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D012371:Robotics; D013119:Spinal Cord Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*