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  4. Kinematic and Neuromuscular Adaptations in Incomplete Spinal Cord Injury after High- versus Low-Intensity Locomotor Training

Kinematic and Neuromuscular Adaptations in Incomplete Spinal Cord Injury after High- versus Low-Intensity Locomotor Training

JOURNAL OF NEUROTRAUMA, 2019 · DOI: 10.1089/neu.2018.5900 · Published: June 15, 2019

Spinal Cord InjuryNeurorehabilitationRehabilitation

Simple Explanation

This study explores how different intensities of walking training affect movement and muscle coordination in people with incomplete spinal cord injuries. Participants underwent both high-intensity and low-intensity training sessions to see which approach led to better walking mechanics. The researchers measured things like joint movement, muscle activation patterns, and walking speed to understand how each training type influenced these factors. The goal was to see if high-intensity training improves walking without causing abnormal movement patterns. The results showed that high-intensity training led to improvements in joint movement, muscle coordination, and walking speed. This suggests that pushing harder during walking training can help people with spinal cord injuries walk better.

Study Duration
4 to 6 weeks for each intervention, with a 4-week washout period
Participants
12 participants with chronic (>1 year) incomplete spinal cord injury (iSCI)
Evidence Level
Level II; Randomized Crossover Design

Key Findings

  • 1
    High-intensity locomotor training (LT) resulted in significant improvements in sagittal-plane joint excursions (hip and knee) compared to low-intensity LT.
  • 2
    Neuromuscular complexity, measured by the number of synergies required to explain EMG variance, increased after high-intensity LT but not after low-intensity LT.
  • 3
    Improvements in hip joint excursion were correlated with improvements in treadmill speed, suggesting a relationship between kinematic changes and locomotor function.

Research Summary

The study investigated the effects of high- versus low-intensity locomotor training (LT) on kinematic and neuromuscular coordination in individuals with incomplete spinal cord injury (iSCI). High-intensity LT led to significant improvements in joint kinematics and neuromuscular complexity compared to low-intensity LT, suggesting that training intensity is an important factor in rehabilitation. Changes in hip joint excursion were found to be predictive of changes in walking speed, highlighting the importance of kinematic improvements in locomotor function.

Practical Implications

Rehabilitation Strategies

High-intensity locomotor training should be considered as a key component in rehabilitation programs for individuals with iSCI to improve walking function.

Targeted Interventions

Therapists should focus on improving hip joint excursion and neuromuscular complexity to enhance locomotor outcomes in iSCI patients.

Personalized Training

Training programs should be tailored to achieve specific heart rate intensity targets to maximize the benefits of locomotor training.

Study Limitations

  • 1
    Small sample size limits the generalizability of the findings.
  • 2
    Assessment of locomotor performance was conducted on a treadmill, which may not fully reflect overground walking.
  • 3
    Potential order effects due to the crossover design may have influenced the results despite the washout period.

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