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Improved Intralimb Coordination in People With Incomplete Spinal Cord Injury Following Training With Body Weight Support and Electrical Stimulation

EC Field-Fote, PT, PhD, is Assistant Professor, Division of Physical Therapy and The Miami Project to Cure Paralysis, University of Miami School of Medicine, Coral Gables, Fla.
D Tepavac, PhD, is Assistant Professor, Department of Biomedical Engineering, University of Miami

Address all correspondence to Dr Field-Fote at Division of Physical Therapy, University of Miami, 5915 Ponce de Leon Blvd, 5th Floor, Coral Gables, FL 33146 (USA) (edee{at}miami.edu)

Background and Purpose. Limb coordination is an element of motor control that is frequently disrupted following spinal cord injury (SCI). The authors assessed intralimb coordination in subjects with SCI following a 12-week program combining body weight support, electrical stimulation, and treadmill training. Subjects. Fourteen subjects with long-standing (mean time post-SCI=70 months, range=12–171 months), incomplete SCI participated. Three subjects without SCI provided data for comparison. Methods. A vector-based technique was used to assign values to the frame-by-frame changes in hip/knee angle, and vector analysis techniques were used to assess how closely the hip/knee angles of each step cycle resembled those of every other step cycle. Overground and treadmill walking speeds also were measured. Results. Following training, 9 of the 14 subjects with SCI demonstrated greater intercycle agreement. Mean overground and treadmill walking speeds improved (84% and 158%, respectively). Discussion and Conclusion. The intervention used in this study is based on our current understanding of the role of afferent input in the production of walking. Although the study sample was small and there was no control group, results suggest that training may improve intralimb coordination in people with SCI.

Key Words: Body weight support • Coordination • Electrical stimulation • Spinal cord injury • Treadmill training • Walking

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