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Weight-supported treadmill vs over-ground training for walking after acuteincomplete SC

Résumé Objective: To compare the efficacy of step training with body weight support on a treadmill (BWSTT) withover-ground practice to the efficacy of a defined over-ground mobility therapy (CONT) in patients with incomplete spinalcord injury (SCI) admitted for inpatient rehabilitation. Methods: A total of 146 subjects from six regional centers within 8 weeks of SCI were entered in a single-blinded, multicenter, randomized clinical trial (MRCT). Subjects were graded on theAmerican Spinal Injury Association Impairment Scale (ASIA) as B, C, or D with levels from C5 to L3 and had a Functional Independence Measure for locomotion (FIM-L) score ⬍4. They received 12 weeks of equal time of BWSTT or CONT. Primary outcomes were FIM-L for ASIA B and C subjects and walking speed for ASIA C and D subjects 6 months afterSCI. Results: No significant differences were found at entry between treatment groups or at 6 months for FIM-L (n ⫽108)or walking speed and distance (n ⫽72). In the upper motor neuron (UMN) subjects, 35% of ASIA B, 92% of ASIA C, andall ASIA D subjects walked independently. Velocities for UMN ASIA C and D subjects were not significantly different forBWSTT (1.1 ⫾0.6 m/s, n ⫽30) and CONT (1.1 ⫾0.7, n ⫽25) groups. Conclusions: The physical therapy strategies of bodyweight support on a treadmill and defined overground mobility therapy did not produce different outcomes. This finding was partly due to the unexpectedly high percentage of American Spinal Injury Association C subjects who achieved functional walking speeds, irrespective of treatment. The results provide new insight into disability after incompletespinal cord injury and affirm the importance of the multicenter, randomized clinical trial to test rehabilitation strategies.
Auteurs

B. Dobkin, FRCP; D. Apple, H. Barbeau, M. Basso, EdD; A. Behrman, D. Deforge, J. Ditunno, MD; G. Dudley, R. Elashoff, L. Fugate, S. Harkema, M. Saulino, M. Scott
Titre de revue/journal, volume et numéroNeurology journal
Langue de la publication et/ou de traductionAnglais (langue d’origine)
Année de parution2006
PaysÉtats-Unis
Institutions affiliéesUniversity of California Los Angeles
Lien vers la publicationhttps://www.researchgate.net/publication/292279991_Weight-supported_treadmill_vs_over-ground_training_for_walking_after_acute_incomplete_SCI
Type d’accès à la publicationGratuit
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