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Fox EJ, Tester NJ, Butera KA, et al. Retraining walking adaptability following incomplete spinal cord injury. Spinal Cord Ser Cases. 2017;3:17091doi: 10.1038/s41394-017-0003-1.
Fox, E. J., Tester, N. J., Butera, K. A., Howland, D. R., Spiess, M. R., Castro-Chapman, P. L., & Behrman, A. L. (2017). Retraining walking adaptability following incomplete spinal cord injury. Spinal cord series and cases, 317091. https://doi.org/10.1038/s41394-017-0003-1
Fox, Emily J, et al. "Retraining walking adaptability following incomplete spinal cord injury." Spinal cord series and cases vol. 3 (2017): 17091. doi: https://doi.org/10.1038/s41394-017-0003-1
Fox EJ, Tester NJ, Butera KA, Howland DR, Spiess MR, Castro-Chapman PL, Behrman AL. Retraining walking adaptability following incomplete spinal cord injury. Spinal Cord Ser Cases. 2017 Dec 14;3:17091. doi: 10.1038/s41394-017-0003-1. eCollection 2017. PMID: 29449967; PMCID: PMC5803746.
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Spinal Cord Ser Cases. 2017 Dec 14;3:17091. doi: 10.1038/s41394-017-0003-1. eCollection 2017.

Retraining walking adaptability following incomplete spinal cord injury.

Spinal cord series and cases

Emily J Fox, Nicole J Tester, Katie A Butera, Dena R Howland, Martina R Spiess, Paula L Castro-Chapman, Andrea L Behrman

Affiliations

  1. 1Department of Physical Therapy, University of Florida, Gainesville, FL USA.
  2. 2Brooks Rehabilitation Clinical Research Center, Jacksonville, FL USA.
  3. 3Brain Rehabilitation Research Center, Malcom Randall VAMC, Gainesville, FL USA.
  4. 4Department of Occupational Therapy, University of Florida, Gainesville, FL USA.
  5. 5Department of Neurological Surgery, Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY USA.
  6. 6Robley Rex VA Medical Center, Louisville, KY USA.
  7. 7Hocoma AG, Volketswil, Switzerland.
  8. 8James A. Haley VAMC, Tampa, FL USA.
  9. 9Department of Psychiatry and Behavioral Neuroscience, University of South Florida, Tampa, FL USA.

PMID: 29449967 PMCID: PMC5803746 DOI: 10.1038/s41394-017-0003-1

Abstract

INTRODUCTION: Functional walking requires the ability to modify one's gait pattern to environmental demands and task goals-gait adaptability. Following incomplete spinal cord injury (ISCI), gait rehabilitation such as locomotor training (Basic-LT) emphasizes intense, repetitive stepping practice. Rehabilitation approaches focusing on practice of gait adaptability tasks have not been established for individuals with ISCIs but may promote recovery of higher level walking skills. The primary purpose of this case series was to describe and determine the feasibility of administering a gait adaptability retraining approach-Adapt-LT-by comparing the dose and intensity of Adapt-LT to Basic-LT.

CASE PRESENTATION: Three individuals with ISCIs (>1 year, AIS C or D) completed three weeks each (15 sessions) of Basic-LT and Adapt-LT. Interventions included practice on a treadmill with body weight support and practice overground (≥30 mins total). Adapt-LT focused on speed changes, obstacle negotiation, and backward walking. Training parameters (step counts, speeds, perceived exertion) were compared and outcomes assessed pre and post interventions. Based on completion of the protocol and similarities in training parameters in the two interventions, it was feasible to administer Adapt-LT with a similar dosage and intensity as Basic-LT. Additionally, the participants demonstrated gains in walking function and balance following each training type.

DISCUSSION: Rehabilitation that includes stepping practice with adaptability tasks is feasible for individuals with ISCIs. Further investigation is needed to determine the efficacy of Adapt-LT.

Conflict of interest statement

Compliance with ethical standardsThe authors declare that they have no competing interests.The contents are solely the responsibility of the authors and do not necessarily represent the official views

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