Gait training in human spinal cord injury using electromechanical systems: effect of device type and patient characteristics.
OBJECTIVE
To report the clinical improvements in spinal cord injury (SCI) patients associated with intensive gait training using electromechanical systems according to patient characteristics.


METHODS
Prospective longitudinal study.


METHODS
Inpatient SCI rehabilitation center.


METHODS
Adults with SCI (n=130).


METHODS
Patients received locomotor training with 2 different electromechanical devices, 5 days per week for 8 weeks.


METHODS
Lower-extremity motor score, Walking Index for Spinal Cord Injury, and 10-meter walking test data were collected at the baseline, midpoint, and end of the program. Patients were stratified according to the American Spinal Injury Association (ASIA) category, time since injury, and injury etiology. A subgroup of traumatic ASIA grade C and D patients were compared with data obtained from the European Multicenter Study about Human Spinal Cord Injury (EM-SCI).


RESULTS
One hundred and five patients completed the program. Significant gains in lower-limb motor function and gait were observed for both types of electromechanical device systems, to a similar degree. The greatest rate of improvement was shown in the motor incomplete SCI patients, and for patients <6 months postinjury. The positive response associated with training was not affected by injury etiology, age, sex, or lesion level. The trajectory of improvement was significantly enhanced relative to patients receiving the conventional standard of care without electromechanical systems (EM-SCI).


CONCLUSIONS
The use of electromechanical systems for intensive gait training in SCI is associated with a marked improvement in lower-limb motor function and gait across a diverse range of patients and is most evident in motor incomplete patients, and for patients who begin the regimen early in the recovery process.
Department of Spinal Cord Injury, Institut Guttmann, Hospital de Neurorehabilitació, Institut Universitari adscrit a la Universitat Autònoma de Barcelona, Barcelona, Spain. jbenito@guttmann.com
Jesús
J
Benito-Penalva
Dylan J
DJ
Edwards
Eloy
E
Opisso
Mar
M
Cortes
Raquel
R
Lopez-Blazquez
Narda
N
Murillo
Ursula
U
Costa
Jose M
JM
Tormos
Joan
J
Vidal-Samsó
Josep
J
Valls-Solé
Josep
J
Medina
D000328:Adult; D000367:Age Factors; D000368:Aged; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000295:instrumentation*; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012737:Sex Factors; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D016138:Walking; D055815:Young Adult