scholarly journals Robot-assisted locomotor training did not improve walking function in patients with chronic incomplete spinal cord injury: A randomized clinical trial

2019 ◽  
Vol 51 (5) ◽  
pp. 385-389 ◽  
Author(s):  
A Piira ◽  
A Lannem ◽  
M Sørensen ◽  
T Glott ◽  
R Knutsen ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Randomized Clinical Trial ◽  
Locomotor Training ◽  
Incomplete Spinal Cord Injury ◽  
Robot Assisted ◽  
Cord Injury

scholarly journals The Effect of Perturbation-Based Balance Training and Conventional Intensive Balance Training on Reactive Stepping Ability in Individuals With Incomplete Spinal Cord Injury or Disease: A Randomized Clinical Trial

2021 ◽  
Vol 12 ◽  
Author(s):  
Janelle Unger ◽  
Katherine Chan ◽  
Jae W. Lee ◽  
B. Catharine Craven ◽  
Avril Mansfield ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Randomized Clinical Trial ◽  
Balance Training ◽  
Drop Out ◽  
Incomplete Spinal Cord Injury ◽  
Clinical Trial Registration ◽  
Cord Injury ◽  
Reactive Stepping

Introduction: Impaired balance leads to falls in individuals with motor incomplete spinal cord injury or disease (iSCI/D). Reactive stepping is a strategy used to prevent falls and Perturbation-based Balance Training (PBT) can improve this ability.Objective: The objective of this study was to determine if PBT results in greater improvements in reactive stepping ability than frequency-matched Conventional Intensive Balance Training (CIBT) in adults with iSCI/D.Design: Randomized clinical trial.Setting: Tertiary SCI/D rehabilitation center.Participants: Twenty-one adults with chronic (>1 year) iSCI/D were randomized. Due to one drop out 20 participants completed the study.Methods: Participants were randomly allocated to complete either PBT or CIBT three times per week for 8 weeks. Both programs included challenging static and dynamic balance tasks, but the PBT group also experienced manual external balance perturbations.Main Outcome Measures: Assessments of reactive stepping ability using the Lean-and-Release test were completed at baseline, and after 4 and 8 weeks of training, and 3 and 6 months after training completion. A blinded assessor evaluated secondary outcomes.Results: Twenty-five participants were screened and 21 consented; one withdrew. Ten PBT and 10 CIBT participants were included in analyses. Across all participants there were improvements in reactive stepping ability (p = 0.049), with retention of improvements at follow up assessments. There were no differences in reactive stepping ability between groups [median (interquartile range): PBT 0.08 (0.68); CIBT 0.00 (0.22)]. One participant in the PBT group experienced a non-injurious fall during training.Conclusions: Balance training is beneficial for individuals with iSCI/D, but the addition of manual perturbations (i.e., PBT) did not prove advantageous for performance on a measure of reactive stepping ability.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT02960178.

scholarly journals Influence of a Locomotor Training Approach on Walking Speed and Distance in People With Chronic Spinal Cord Injury: A Randomized Clinical Trial

2011 ◽  
Vol 91 (1) ◽  
pp. 48-60 ◽  
Author(s):  
Edelle C. Field-Fote ◽  
Kathryn E. Roach
Keyword(s):  
Clinical Trial ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Randomized Clinical Trial ◽  
Effect Size ◽  
Walking Speed ◽  
Effect Sizes ◽  
Walking Distance ◽  
Locomotor Training ◽  
Cord Injury

BackgroundImpaired walking limits function after spinal cord injury (SCI), but training-related improvements are possible even in people with chronic motor incomplete SCI.ObjectiveThe objective of this study was to compare changes in walking speed and distance associated with 4 locomotor training approaches.DesignThis study was a single-blind, randomized clinical trial.SettingThis study was conducted in a rehabilitation research laboratory.ParticipantsParticipants were people with minimal walking function due to chronic SCI.InterventionParticipants (n=74) trained 5 days per week for 12 weeks with the following approaches: treadmill-based training with manual assistance (TM), treadmill-based training with stimulation (TS), overground training with stimulation (OG), and treadmill-based training with robotic assistance (LR).MeasurementsOverground walking speed and distance were the primary outcome measures.ResultsIn participants who completed the training (n=64), there were overall effects for speed (effect size index [d]=0.33) and distance (d=0.35). For speed, there were no significant between-group differences; however, distance gains were greatest with OG. Effect sizes for speed and distance were largest with OG (d=0.43 and d=0.40, respectively). Effect sizes for speed were the same for TM and TS (d=0.28); there was no effect for LR. The effect size for distance was greater with TS (d=0.16) than with TM or LR, for which there was no effect. Ten participants who improved with training were retested at least 6 months after training; walking speed at this time was slower than that at the conclusion of training but remained faster than before training.LimitationsIt is unknown whether the training dosage and the emphasis on training speed were optimal. Robotic training that requires active participation would likely yield different results.ConclusionsIn people with chronic motor incomplete SCI, walking speed improved with both overground training and treadmill-based training; however, walking distance improved to a greater extent with overground training.

Repetitive Mass Practice or Focused Precise Practice for Retraining Walking After Incomplete Spinal Cord Injury? A Pilot Randomized Clinical Trial

2013 ◽  
Vol 28 (4) ◽  
pp. 314-324 ◽  
Author(s):  
Jaynie F. Yang ◽  
Kristin E. Musselman ◽  
Donna Livingstone ◽  
Kelly Brunton ◽  
Gregory Hendricks ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Randomized Clinical Trial ◽  
Incomplete Spinal Cord Injury ◽  
Cord Injury
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