The Evolution of Walking-Related Outcomes Over the First 12 Weeks of Rehabilitation for Incomplete Traumatic Spinal Cord Injury: The Multicenter Randomized Spinal Cord Injury Locomotor Trial

Neurorehabil Neural Repair, 2007 · DOI: 10.1177/1545968306295556 · Published: January 1, 2007

Simple Explanation

This study examined how people with incomplete spinal cord injuries improved their walking ability during the first 12 weeks of rehabilitation. Patients received either body weight-supported treadmill training or conventional overground mobility training. The study found that most patients with some initial motor function (ASIA C and D) achieved functional walking ability, while those with very limited motor function (ASIA B) showed less improvement. The researchers found that the time after the injury is an important factor to consider when evaluating patients for clinical trials focused on improving walking ability.

Study Duration

12 Weeks

Participants

107 ASIA C and D patients and 38 ASIA B patients

Evidence Level

Level I, Randomized Controlled Trial

Key Findings

1
No significant differences were found between body weight-supported treadmill training (BWSTT) and conventional overground mobility intervention (CONT) groups in terms of walking speed, Functional Independence Measure (FIM-L) for walking, and lower extremity motor score (LEMS).
2
Most ASIA C and D patients achieved functional walking ability by the end of the 12-week rehabilitation period.
3
Walking speed of ≥ 0.6 m/s correlated with a LEMS near 40 or higher.

Research Summary

The Spinal Cord Injury Locomotor Trial (SCILT) compared body weight-supported treadmill training (BWSTT) with conventional overground mobility intervention (CONT) in patients with incomplete traumatic SCI. No significant differences were found between the two groups at the end of the 12-week treatment period for walking speed, FIM-L, or LEMS. The study suggests that the time after injury is an important factor for patient selection in clinical trials focused on improving mobility outcomes.

Practical Implications

Trial Design

Future clinical trials can be more efficient by considering the time after injury when including patients with spinal cord injuries.

Rehabilitation Strategies

Both BWSTT and conventional overground training are effective for improving walking outcomes in patients with incomplete SCI.

Patient Expectations

Clinicians can provide realistic expectations to patients with incomplete SCI regarding their potential for regaining functional walking ability based on their ASIA grade and time since injury.

Study Limitations

1
The reliability of ASIA grade examination performed at approximately 96 hours after SCI bears some uncertainty.
2
The study may not be generalizable to patients with complete SCI.
3
The study did not evaluate the long-term effects of the interventions beyond 12 months.

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