Locomotor training: Experiencing the changing body

Hannold, Elizabeth M.; Young, Mary Ellen; Rittman, Maude; Bowden, Mark G.; Behrman, Andrea L.

doi:10.1682/jrrd.2005.07.0122

Cited by 17 publications

(10 citation statements)

References 43 publications

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“…In acknowledging these concerns, we should note that our sample size of 11 participants was comparable to that found in previous studies of persons with iSCI [30,37]. Another limitation of the current study was the lack of diary usage to track the occurrence of sickness, physical pain, fatigue, and special occasions that may have influenced the number of steps taken by participants.…”

Section: Discussionmentioning

confidence: 69%

Reliability of daily step activity monitoring in adults with incomplete spinal cord injury

Ishikawa

Stevens²,

Kang³

et al. 2011

JRRD

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Abstract-We determined the number of days of step activity monitoring required to establish stable measures of walking activity in adults with incomplete spinal cord injury (iSCI). Eleven individuals with iSCI (mean age 49 +/-14 years) wore a StepWatch Activity Monitor during waking hours for 7 consecutive days. We used generalizability theory to identify sources of variance in daily step counts and determine the minimum number of days necessary to obtain a reliability coefficient (G-coefficient) greater than or equal to 0.80. Average daily step activity (DSA) was 1,281 +/-1,594 steps. Participants and days accounted for 70.9% and 1.3% of total variance in DSA, respectively, while unidentifiable error accounted for 27.8% of the total variance in DSA. A minimum of 2 days was required to achieve a G-coefficient greater than or equal to 0.80. An acceptably stable measure of walking activity in adults with iSCI can be obtained by averaging step count values from any 2-day period in a week. Results from this investigation should be useful in evaluating the effect of activitybased programs designed to enhance locomotor function in persons with iSCI.

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Section: Discussionmentioning

confidence: 69%

Reliability of daily step activity monitoring in adults with incomplete spinal cord injury

Ishikawa

Stevens²,

Kang³

et al. 2011

JRRD

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“…Another strategy to improve walking after SCI is to administer BWS treadmill training combined with functional electrical stimulation (FES). Its benefits have been noted in terms of CNS regeneration, initiation of stepping, improving foot clearance, knee extension, and strength in both acute and chronic participants [41–43]. However, a recent meta-analysis revealed that people with SCI who used FES did not significantly increase their walking speed and capacity when compared with patients who were treated with other approaches [40].…”

Section: Discussionmentioning

confidence: 99%

Robot-assisted gait training (Lokomat) improves walking function and activity in people with spinal cord injury: a systematic review

Nam

Kim

Kwon

et al. 2017

J NeuroEngineering Rehabil

202

127

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Robot-assisted gait training (RAGT) after spinal cord injury (SCI) induces several different neurophysiological mechanisms to restore walking ability, including the activation of central pattern generators, task-specific stepping practice and massed exercise. However, there is no clear evidence for the optimal timing and efficacy of RAGT in people with SCI. The aim of our study was to assess the effects of RAGT on improvement in walking-related functional outcomes in patients with incomplete SCI compared with other rehabilitation modalities according to time elapsed since injury. This review included 10 trials involving 502 participants to meta-analysis. The acute RAGT groups showed significantly greater improvements in gait distance, leg strength, and functional level of mobility and independence than the over-ground training (OGT) groups. The pooled mean difference was 45.05 m (95% CI 13.81 to 76.29, P = 0.005, I2 = 0%; two trials, 122 participants), 2.54 (LEMS, 95% CI 0.11 to 4.96, P = 0.04, I2 = 0%; three trials, 211 participants) and 0.5 (WISCI-II and FIM-L, 95% CI 0.02 to 0.98, P = 0.04, I2 = 67%; three trials, 211 participants), respectively. In the chronic RAGT group, significantly greater improvements in speed (pooled mean difference = 0.07 m/s, 95% CI 0.01 to 0.12, P = 0.01, I2 = 0%; three trials, 124 participants) and balance measured by TUG (pooled mean difference = 9.25, 95% CI 2.76 to 15.73, P = 0.005, I2 = 74%; three trials, 120 participants) were observed than in the group with no intervention. Thus, RAGT improves mobility-related outcomes to a greater degree than conventional OGT for patients with incomplete SCI, particularly during the acute stage. RAGT treatment is a promising technique to restore functional walking and improve locomotor ability, which might enable SCI patients to maintain a healthy lifestyle and increase their level of physical activity.Trial registrationPROSPERO (CRD 42016037366). Registered 6 April 2016.

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“…To answer this question, we entered an LT site and asked patients to interpret the meanings of the changes in their bodies. Previous studies have retrospectively examined perceptions of the changed body after iSCI (Chau et al, 2008; Edgerton et al, 1991; Hannold, Young, Rittman, & Behrman, 2006; Nymark et al, 1998; Seymour, 1998), but few have examined changes occurring during the course of the therapy. We interviewed persons with iSCI ( n = 5) three times throughout their LT to explore how they told their stories of their changing bodies across a 12-week time period.…”

mentioning

confidence: 99%

Thinking Through Every Step: How People With Spinal Cord Injuries Relearn to Walk

et al. 2013

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In this article we explore how people with incomplete spinal cord injury (iSCI) create meaning out of their changing bodies as they undergo a therapeutic intervention called locomotor training (LT). Therapeutic interventions like LT are used to promote the recovery of walking ability among individuals with iSCI. The chronological nature of this study--interviews at three points throughout the 12-week intervention--enhances understanding of the recovering self after spinal cord injury. Drawing on a constructivist theoretical framework, we organize data according to three narrative frames. Participants interpreted LT as (a) a physical change that was meaningful because of its social significance, (b) a coping strategy for dealing with the uncertainty of long-term recovery, and (c) a moral strategy to reconstitute the self. We offer findings that lay the conceptual groundwork for generating new knowledge about what is important to people with iSCI as they relearn how to walk.

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Locomotor training: Experiencing the changing body

Cited by 17 publications

References 43 publications

Reliability of daily step activity monitoring in adults with incomplete spinal cord injury

Reliability of daily step activity monitoring in adults with incomplete spinal cord injury

Robot-assisted gait training (Lokomat) improves walking function and activity in people with spinal cord injury: a systematic review

Thinking Through Every Step: How People With Spinal Cord Injuries Relearn to Walk

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