scholarly journals Daily Stepping in Individuals With Motor Incomplete Spinal Cord Injury

2010 ◽  
Vol 90 (2) ◽  
pp. 224-235 ◽  
Author(s):  
Poonam Saraf ◽  
Miriam R. Rafferty ◽  
Jennifer L. Moore ◽  
Jennifer H. Kahn ◽  
Kathryn Hendron ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Knee Extension ◽  
Small Sample ◽  
Substantial Contribution ◽  
Activity Limitations ◽  
Incomplete Spinal Cord Injury ◽  
Knee Extension Strength ◽  
Cord Injury ◽  
Walking Performance

BackgroundIn individuals with motor incomplete spinal cord injury (SCI), ambulatory function determined in the clinical setting is related to specific measures of body structure and function and activity limitations, although few studies have quantified the relationship of these variables with daily stepping (steps/day).ObjectiveThe aim of this study was to quantify daily stepping in ambulatory individuals with SCI and its relationship with clinical walking performance measures and specific demographics, impairments, and activity limitations.DesignA cross-sectional study was performed to estimate relationships among clinical variables to daily stepping in self-identified community versus non–community (household) walkers.MethodsAverage daily stepping was determined in 50 people with chronic, motor incomplete SCI. Data for clinical and self-report measures of walking performance also were collected, and their associations with daily stepping were analyzed using correlation and receiver operating characteristic (ROC) analyses. Relationships between daily stepping and the measures of demographics, impairments, and activity limitations were identified using correlation and regression analyses.ResultsThe ROC analyses revealed a significant discriminative ability between self-reported community and non–community walkers using clinical gait measures and daily stepping. Stepping activity generally was low throughout the sample tested, however, with an average of approximately 2,600 steps/day. Knee extension strength (force-generating capacity) and static balance were the primary variables related to daily stepping, with metabolic efficiency and capacity and balance confidence contributing to a lesser extent.LimitationsThe small sample size and use of specific impairment-related measures were potential limitations of the study.ConclusionsDaily stepping is extremely limited in individuals with incomplete SCI, with a potentially substantial contribution of impairments in knee extension strength and balance.

scholarly journals Ambulatory assistive devices and walking performance in patients with incomplete spinal cord injury

Spinal Cord ◽  
2013 ◽  
Vol 52 (3) ◽  
pp. 216-219 ◽  
Author(s):  
W Saensook ◽  
S Phonthee ◽  
K Srisim ◽  
L Mato ◽  
P Wattanapan ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Assistive Devices ◽  
Incomplete Spinal Cord Injury ◽  
Cord Injury ◽  
Walking Performance

scholarly journals Cosine tuning determines plantarflexors' activities during human upright standing and is affected by incomplete spinal cord injury

2020 ◽  
Author(s):  
Kai Lon Fok ◽  
Jae W Lee ◽  
Janelle Unger ◽  
Katherine Chan ◽  
Daichi Nozaki ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Spinal Cord Injury ◽  
Nervous System ◽  
Knee Extension ◽  
Medial Gastrocnemius ◽  
Quiet Standing ◽  
Incomplete Spinal Cord Injury ◽  
Cord Injury ◽  
The Central Nervous System

Plantarflexors such as the soleus (SOL) and medial gastrocnemius (MG) play key roles in controlling bipedal stance; however, how the central nervous system controls the activation levels of these plantarflexors is not well understood. Here we investigated how the central nervous system controls the plantarflexors' activation level during quiet standing in a cosine tuning manner where the maximal activation is achieved in a preferred direction (PD). Further, we investigated how spinal cord injury affects these plantarflexors' activations. Thirteen healthy adults (AB) and thirteen individuals with chronic, incomplete spinal cord injury (iSCI) performed quiet standing trials. Their body kinematics, kinetics as well as electromyography signals from the MG and SOL were recorded. In the AB-group, we found that the plantarflexors followed the cosine tuning manner during quiet standing. That is, MG was most active when the ratio of plantarflexion torque to knee extension torque was approximately 2:-3, while SOL was most active when the ratio was approximately 2:1. This suggests that the SOL muscle despite being a monoarticular muscle is sensitive to both ankle plantarflexion and knee extension during quiet standing. The difference in the PDs accounts for the phasic activity of MG and for the tonic activity of SOL. Unlike the AB-group, the MG's activity was similar to the SOL's activity in the iSCI-group, and the SOL PDs were similar to the ones in the AB-group. This result suggests that chronic iSCI affects the control strategy, i.e., cosine tuning, for MG, which may affect standing balance in individuals with iSCI.

scholarly journals Eccentric-focused rehabilitation promotes myelin plasticity in individuals with chronic, incomplete spinal cord injury

2020 ◽  
Author(s):  
Timothy D. Faw ◽  
Bimal Lakhani ◽  
Hanwen Liu ◽  
Huyen T. Nguyen ◽  
Petra Schmalbrock ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Motor Learning ◽  
Human Study ◽  
Brain Regions ◽  
Small Sample ◽  
Incomplete Spinal Cord Injury ◽  
Link Type ◽  
Cord Injury ◽  
Ventral Spinal Cord

AbstractBackgroundMyelin plasticity has emerged as a novel mechanism by which the nervous system can change with experience, offering new potential for rehabilitation-induced recovery after neurotrauma. This first-in-human study investigated whether innovative, downhill locomotor rehabilitation promotes myelin plasticity in individuals with chronic, incomplete spinal cord injury (SCI).MethodsOf 20 individuals with SCI that enrolled, 4 passed the imaging screen and had myelin water imaging (MWI) before and after a 12-week (3 times/week) downhill locomotor treadmill training program (SCI+DH). One individual was excluded for imaging artifacts. Uninjured control participants (n=7) had two MWI sessions within the same day. Changes in myelin water fraction (MWF), a histopathologically-validated myelin biomarker, were analyzed in a priori motor learning and non-motor learning brain regions and the cervical spinal cord using statistical approaches appropriate for small sample sizes.ResultsWithin SCI+DH individuals, significantly more motor learning regions showed increased MWF than non-motor learning regions (p<.05). Compared to Control, MWF in the SCI+DH group increased in white matter underlying postcentral and precuneus cortices, combined motor learning brain regions, and ventral spinal cord (p<.05). To account for small sample size, an estimation-based approach showed the pattern of MWF increase was specific to training and region.ConclusionDownhill training increased MWF in brain regions specifically associated with motor learning and in the ventral spinal cord.Trial RegistrationClincialTrials.gov (NCT02498548, NCT02821845)FundingNational Institutes of Health [F31NS096921 (TDF), R21HD082808 (DMB)], Craig H. Neilsen Foundation [316282 (DMB)], Foundation for Physical Therapy Research [Promotion of Doctoral Studies Level II Scholarship (TDF)]

Using a saddle-assistive device equipped with mechanical orthosis for walking of the person with incomplete spinal cord injury

2021 ◽  
pp. 095441192110201
Author(s):  
Akbar Hojjati Najafabadi ◽  
Saeid Amini ◽  
Farzam Farahmand
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Reaction Force ◽  
Assistive Devices ◽  
Assistive Device ◽  
Walking Ability ◽  
Vertical Force ◽  
Incomplete Spinal Cord Injury ◽  
Combined Application ◽  
Cord Injury

The majority of the people with incomplete spinal cord injury lose their walking ability, due to the weakness of their muscle motors in providing torque. As a result, developing assistive devices to improve their conditionis of great importance. In this study, a combined application of the saddle-assistive device (S-AD) and mechanical medial linkage or thosis was evaluated to improve the walking ability in patients with spinal cord injury in the gait laboratory. This mobile assistive device is called the saddle-assistive device equipped with medial linkage or thosis (S-ADEM). In this device, a mechanical orthosis was used in a wheeled walker as previously done in the literature. Initially, for evaluation of the proposed assistive device, the experimental results related to the forces and torques exerted on the feet and upper limbs of a person with the incomplete Spinal Cord Injury (SCI) during walking usingthe standard walker were compared with an those obtained from using the S-ADEM on an able-bodied subject. It was found that using this combination of assistive devices decreases the vertical force and torque on the foot at the time of walking by 53% and 48%, respectively compared to a standard walker. Moreover, the hand-reaction force on the upper limb was negligible instanding and walking positions usingthe introduced device. The findings of this study revealed that the walking ability of the patients with incomplete SCI was improved using the proposed device, which is due to the bodyweight support and the motion technology used in it.

Sign in / Sign up

Export Citation Format

Share Document