OBJECTIVES: To assess (1) the frequency and magnitude of differences between self-selected and maximal walking capacity following spinal cord injury (SCI) by using the Walking Index for Spinal Cord Injury (WISCI) and (2) how these levels differ in efficiency and velocity. DESIGN: Prospective cohort. SETTING: Academic medical center. PARTICIPANTS: Fifty people with chronic incomplete SCI. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Subjects ambulated at the level used in the community (self-selected WISCI) and the highest level possible (maximal WISCI). Velocity (in m/s), Physiological Cost Index (PCI), and Total Heart Beat Index (THBI) were calculated. Differences were compared using the paired t test (parametric) or Wilcoxon signed-rank test (nonparametric). RESULTS: For 36 subjects, maximal WISCI was higher than self-selected WISCI; 21 subjects showed an increase of 3 levels or more. Ambulatory velocity was higher for self-selected WISCI compared with maximal WISCI (.68 m/s vs .56 m/s, P<.001). PCI and THBI at self-selected WISCI were lower than at maximal WISCI (PCI, 0.99 beats/m vs 1.48 beats/m, P<.001; THBI, 3.39 beats/m vs 4.75 beats/m, P<.001). CONCLUSIONS: Many people with chronic SCI are capable of ambulating at multiple levels. For these people, ambulation at self-selected WISCI was more efficient as evidenced by greater velocity and decreased PCI and THBI. The findings have implications for assessing walking capacity within the context of clinical trials.
OBJECTIVES: To assess (1) the frequency and magnitude of differences between self-selected and maximal walking capacity following spinal cord injury (SCI) by using the Walking Index for Spinal Cord Injury (WISCI) and (2) how these levels differ in efficiency and velocity. DESIGN: Prospective cohort. SETTING: Academic medical center. PARTICIPANTS: Fifty people with chronic incomplete SCI. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Subjects ambulated at the level used in the community (self-selected WISCI) and the highest level possible (maximal WISCI). Velocity (in m/s), Physiological Cost Index (PCI), and Total Heart Beat Index (THBI) were calculated. Differences were compared using the paired t test (parametric) or Wilcoxon signed-rank test (nonparametric). RESULTS: For 36 subjects, maximal WISCI was higher than self-selected WISCI; 21 subjects showed an increase of 3 levels or more. Ambulatory velocity was higher for self-selected WISCI compared with maximal WISCI (.68 m/s vs .56 m/s, P<.001). PCI and THBI at self-selected WISCI were lower than at maximal WISCI (PCI, 0.99 beats/m vs 1.48 beats/m, P<.001; THBI, 3.39 beats/m vs 4.75 beats/m, P<.001). CONCLUSIONS: Many people with chronic SCI are capable of ambulating at multiple levels. For these people, ambulation at self-selected WISCI was more efficient as evidenced by greater velocity and decreased PCI and THBI. The findings have implications for assessing walking capacity within the context of clinical trials.
Authors: Garima Shah; Alison R Oates; Tarun Arora; Joel L Lanovaz; Kristin E Musselman Journal: J Spinal Cord Med Date: 2017-09-06 Impact factor: 1.985
Authors: Oliver Jansen; Thomas A Schildhauer; Renate C Meindl; Martin Tegenthoff; Peter Schwenkreis; Matthias Sczesny-Kaiser; Dennis Grasmücke; Christian Fisahn; Mirko Aach Journal: Global Spine J Date: 2017-07-07
Authors: Marc Bolliger; Andrew R Blight; Edelle C Field-Fote; Kristin Musselman; Serge Rossignol; Dorothy Barthélemy; Laurent Bouyer; Milos R Popovic; Jan M Schwab; Michael L Boninger; Keith E Tansey; Giorgio Scivoletto; Naomi Kleitman; Linda A T Jones; Dany H Gagnon; Sylvie Nadeau; Dirk Haupt; Lea Awai; Chris S Easthope; Björn Zörner; Ruediger Rupp; Dan Lammertse; Armin Curt; John Steeves Journal: Spinal Cord Date: 2018-04-27 Impact factor: 2.772