Improving walking assessment in subjects with an incomplete spinal cord injury: responsiveness

Hedel, Hubertus J. A. van; Wirz, Markus; Curt, Armin

doi:10.1038/sj.sc.3101853

Cited by 108 publications

(125 citation statements)

References 13 publications

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“…These functions are subserved by supraspinal reticular, vestibular, and cerebellar inputs. 43 As was first described in the 1970s, 44 the strong relationship between volitional control of the lower extremity muscles and walking ability [44][45][46][47][48][49][50][51][52][53][54][55][56] attests to the importance of supraspinal contributions to human walking. During human walking, neuronal activity related to lower extremity movement is represented in the primary motor and sensory cortices.…”

Section: Supraspinal Contributionsmentioning

confidence: 99%

Supraspinal Control Predicts Locomotor Function and Forecasts Responsiveness to Training after Spinal Cord Injury

Field-Fote

Yang

Basso

et al. 2017

Journal of Neurotrauma

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Restoration of walking ability is an area of great interest in the rehabilitation of persons with spinal cord injury. Because many cortical, subcortical, and spinal neural centers contribute to locomotor function, it is important that intervention strategies be designed to target neural elements at all levels of the neuraxis that are important for walking ability. While to date most strategies have focused on activation of spinal circuits, more recent studies are investigating the value of engaging supraspinal circuits. Despite the apparent potential of pharmacological, biological, and genetic approaches, as yet none has proved more effective than physical therapeutic rehabilitation strategies. By making optimal use of the potential of the nervous system to respond to training, strategies can be developed that meet the unique needs of each person. To complement the development of optimal training interventions, it is valuable to have the ability to predict future walking function based on early clinical presentation, and to forecast responsiveness to training. A number of clinical prediction rules and association models based on common clinical measures have been developed with the intent, respectively, to predict future walking function based on early clinical presentation, and to delineate characteristics associated with responsiveness to training. Further, a number of variables that are correlated with walking function have been identified. Not surprisingly, most of these prediction rules, association models, and correlated variables incorporate measures of volitional lower extremity strength, illustrating the important influence of supraspinal centers in the production of walking behavior in humans.

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Section: Supraspinal Contributionsmentioning

confidence: 99%

Supraspinal Control Predicts Locomotor Function and Forecasts Responsiveness to Training after Spinal Cord Injury

Field-Fote

Yang

Basso

et al. 2017

Journal of Neurotrauma

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“…This test is useful in assessing cardiovascular exercise capacity in elderly patients with congestive heart failure or chronic lung disease and walking ability in patients with acquired brain injury. 10,11 Validity and reproducibility of these timed tests on patients with SCI has been well documented by van Hedel et al 11 The Experimental environment gymnasium consists of a 53 m straight hallway with a single 90 1 direction change. The natural environment consisted of a public walkway in a local community.…”

Section: Interventionsmentioning

confidence: 96%

“…This test has been used in gait studies of patients with neurological diseases. 11 6 MWT measures the distance (in meters) walked within 6 min. This test is useful in assessing cardiovascular exercise capacity in elderly patients with congestive heart failure or chronic lung disease and walking ability in patients with acquired brain injury.…”

Section: Interventionsmentioning

confidence: 99%

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

et al. 2007

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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.

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“…However, literature shows that the 10MWT is a validated test to assess walking speed in daily life. 8,9 The current study showed that walking speed on the 10MWT corresponds well with the outdoor mobility SCIM 14 scores, resulting in high specificity and sensitivity when discriminating between patients who walk in the community and those who do not.…”

Section: Study Limitationsmentioning

confidence: 98%

“…7 The 10-meter walking test (10MWT) is a validated short-distance test to measure walking speed in daily life. 8,9 This test can easily be performed in a standardized testing environment. 10 The minimum walking speed required for independent community mobility is not precisely known.…”

Section: Introductionmentioning

confidence: 99%

Ten Meters Walking Speed in Spinal Cord–Injured Patients: Does Speed Predict Who Walks and Who Rolls?

Silfhout

Hosman

Bartels

et al. 2017

Neurorehabil Neural Repair

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Background. Walking speed is assumed to be a key factor in regaining ambulation after spinal cord injury (SCI). However, from the literature it remains unclear which walking speed usually results in independent community ambulation. Objective. The primary aim of this study was to determine at which walking speed SCI patients tend to walk in the community instead of using a wheelchair. The secondary aim was to investigate clinical conditions that favor independent ambulation in the community. Methods. Data from SCI patients were collected retrospectively from the European Multicenter Study about Spinal Cord Injury database. We determined a cutoff walking speed at which the patients tend to walk in the community by plotting a receiver operating characteristics curve, using the Spinal Cord Independence Measure for outdoor mobility. Univariate analyses investigated which factors influence independent community ambulation. Results. A walking speed of 0.59 m/s is the cutoff between patients who do and do not ambulate independently in the community, with a sensitivity of 91.6% and a specificity of 80.3%. Age, injury severity, and lower limb muscle strength have a significant influence on independent community ambulation. Conclusions. Patients with an SCI who regain a walking speed of 0.59 m/s tend to achieve a level of walking effectiveness that allows for independent community walking. Although such patients tend to be younger and less severely injured, this walking speed can be a target for locomotor training in rehabilitation and clinical trials that lead to a meaningful outcome level of community walking.

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Improving walking assessment in subjects with an incomplete spinal cord injury: responsiveness

Cited by 108 publications

References 13 publications

Supraspinal Control Predicts Locomotor Function and Forecasts Responsiveness to Training after Spinal Cord Injury

Supraspinal Control Predicts Locomotor Function and Forecasts Responsiveness to Training after Spinal Cord Injury

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

Ten Meters Walking Speed in Spinal Cord–Injured Patients: Does Speed Predict Who Walks and Who Rolls?

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