Comparison of gait performance on different environmental settings for patients with chronic spinal cord injury

Abstract

Study design: Observational cross-section study. Objectives: The objective of our study was to determine if the influence of a community environment would impact on ASIA D spinal cord injured (SCI) gait performance patients. Our main hypothesis is that an outdoor community environment may influence gait speed and endurance on community ambulating patients. Methods: Ten-Meter Walking (10MWT) and Six-Minute Walking (6MWT) tests were performed on community ambulating SCI research participants (n ¼ 18) in two different environmental conditions: (1) Experimental (indoors Gymnasium) and (2) Natural (community setting). Average gait speed and endurance values were obtained for the two different conditions and analyzed for statistical significance on the nonparametric two-tailed Wilcoxon signed rank test. Results: While no difference was observed on the 10MWT we found an improvement on gait performance on the 6 MWT on a community setting. Conclusions: Our study showed mixed results on environmental influence on gait speed and endurance on ASIA D patient population. While there is no difference on the 10 MWT, there is an improvement on gait performance on the communitary 6MWT.

Validity and reliability of the 10-m walk test and the 6-min walk test in spinal cord injury patients

“…Longer track distances between 50 and 60 m had been utilized in recent studies of SCI subjects. 10,13 Patients were asked to walk at a self-selected speed, but without resting. They were asked to walk at the WISCI level they used in the community (usual WISCI level) in regard to the use of devices (braces/walking aids) and physical assistance.…”

“…Both the 10MWT and the 6MWT have been utilized in studies of SCI patients. [5][6][7][8][9][10][11][12][13][14][15][16] Both tests showed good inter-and intra-rater reliabilities, 5 a good relationship with lower limbs strength 17 and with other walking tests (the WISCI and the 'timed up and go'). 5 Furthermore, both tests seem to have a greater sensitivity to detect changes of performance in less severely injured SCI patients if compared with the WISCI, which has a ceiling effect.…”

“…[25][26][27][28] The distance of the track varied from 85 m, 25 39 m 26 to 20-m corridors with 1801 turns 28 for several studies on stroke subjects. A few studies of SCI defined distances and turns, which varied from non-standardized hallways of 50 feet or more with 901 turns 8 to 53 (reviewed in Olmos et al 10 ) and 60 m, 13 with 901 turns and different surfaces. Several other studies in SCI by the same authors did not identify either the shape of the track or the frequency of turns.…”

“…3 Therefore, the recovery of ambulation has become the target of several pharmacological and rehabilitative approaches 4 and a precise evaluation of ambulation in these patients has become mandatory. Although several walking measures have been suggested for assessment of walking function in patients with SCI, over the past 5 years most studies have focused on the 10-m walk test (10MWT), 5-14 the 6-min walk test (6MWT) [5][6][7][8][9][10]13,15 and the Walking Index for Spinal Cord Injury (WIS-CI). 5,7,9,12,14,[16][17][18][19][20] This set of measures allows a comprehensive assessment of walking function, which includes the use of walking aids, braces, physical assistance, and speed and endurance.…”

Functional walking capacity of subjects with paralyzed knee extensors while walking with an SCO in locked vs unlocked mode

“…Timed walk tests are validated measures of physical performance and overall mobility in the elderly and patients with various medical conditions [17][18][19][20][21], including incomplete spinal cord injury [22][23][24][25][26][27], post-polio syndrome [28][29][30] and lower limb amputations [31][32][33][34]. In subjects with lower limb amputations, the distance walked is well correlated with daily activity and indicative for substantial functional limitations in daily life [33,34].Timed walk tests have not yet been validated specifically for users of KAFOs, but for patients with neurologic conditions that may require fitting of a KAFO such as incomplete SCI, stroke, traumatic brain injury, or multiple sclerosis [35][36][37][38][39][40].…”