OBJECTIVE: To systematically review the evidence for the efficacy of different rehabilitation strategies on functional ambulation following spinal cord injury (SCI). METHODS: A keyword literature search of original articles was used to identify published literature evaluating the effectiveness of any treatment or therapy on functional ambulation in people with SCI. The rigor and quality of each study were scored on standardized scales by two independent reviewers. RESULTS: The search yielded 160 articles, of which 119 were excluded for not meeting our inclusion criteria. The remaining 41 articles covered various strategies for improving gait: bodyweight supported treadmill training (BWSTT) (n=12), functional electrical stimulation (FES) (n=7), braces/orthoses (n=10), or a combination of these (n=12). There is strong evidence from randomized controlled trials that functional ambulation outcomes following body-weight supported treadmill training (BWSTT) are comparable to an equivalent intensity of overground gait training in sub-acute SCI. In chronic SCI, evidence from pre-test/post-test studies shows that BWSTT may be effective in improving functional ambulation. Pre-test/post-test or post-test only studies provide evidence that FES may augment functional ambulation in sub-acute/chronic SCI while braces may afford particular benefits to people with complete SCI to stand up and ambulate with assistive devices. CONCLUSIONS: Rehabilitation strategies that facilitate repeated practice of gait offer the greatest benefits to functional ambulation in sub-acute or chronic SCI. Supportive devices may augment functional ambulation particularly in people with incomplete SCI.
OBJECTIVE: To systematically review the evidence for the efficacy of different rehabilitation strategies on functional ambulation following spinal cord injury (SCI). METHODS: A keyword literature search of original articles was used to identify published literature evaluating the effectiveness of any treatment or therapy on functional ambulation in people with SCI. The rigor and quality of each study were scored on standardized scales by two independent reviewers. RESULTS: The search yielded 160 articles, of which 119 were excluded for not meeting our inclusion criteria. The remaining 41 articles covered various strategies for improving gait: bodyweight supported treadmill training (BWSTT) (n=12), functional electrical stimulation (FES) (n=7), braces/orthoses (n=10), or a combination of these (n=12). There is strong evidence from randomized controlled trials that functional ambulation outcomes following body-weight supported treadmill training (BWSTT) are comparable to an equivalent intensity of overground gait training in sub-acute SCI. In chronic SCI, evidence from pre-test/post-test studies shows that BWSTT may be effective in improving functional ambulation. Pre-test/post-test or post-test only studies provide evidence that FES may augment functional ambulation in sub-acute/chronic SCI while braces may afford particular benefits to people with complete SCI to stand up and ambulate with assistive devices. CONCLUSIONS: Rehabilitation strategies that facilitate repeated practice of gait offer the greatest benefits to functional ambulation in sub-acute or chronic SCI. Supportive devices may augment functional ambulation particularly in people with incomplete SCI.
Authors: Therese E Johnston; Richard L Finson; Brian T Smith; Daniel M Bonaroti; Randal R Betz; M J Mulcahey Journal: J Spinal Cord Med Date: 2003 Impact factor: 1.985
Authors: J D Steeves; D Lammertse; A Curt; J W Fawcett; M H Tuszynski; J F Ditunno; P H Ellaway; M G Fehlings; J D Guest; N Kleitman; P F Bartlett; A R Blight; V Dietz; B H Dobkin; R Grossman; D Short; M Nakamura; W P Coleman; M Gaviria; A Privat Journal: Spinal Cord Date: 2006-12-19 Impact factor: 2.772
Authors: Andrea L Behrman; Anna R Lawless-Dixon; Sandra B Davis; Mark G Bowden; Preeti Nair; Chetan Phadke; Elizabeth M Hannold; Prudence Plummer; Susan J Harkema Journal: Phys Ther Date: 2005-12
Authors: Isabela Peña Pino; Caleb Hoover; Shivani Venkatesh; Aliya Ahmadi; Dylan Sturtevant; Nick Patrick; David Freeman; Ann Parr; Uzma Samadani; David Balser; Andrei Krassioukov; Aaron Phillips; Theoden I Netoff; David Darrow Journal: Front Syst Neurosci Date: 2020-06-30