The utility of upper limb loading device in determining optimal walking ability in ambulatory individuals with spinal cord injury

Hong Kong Physiotherapy Journal, 2021 · DOI: 10.1142/S1013702521500050 · Published: January 18, 2021

Simple Explanation

This study developed an upper limb loading device (ULLD) to measure the amount of weight-bearing on the upper limbs during walking in individuals with spinal cord injury (SCI). The goal was to assess if this device could help determine the optimal walking ability for these individuals. Participants were evaluated for their ability to walk with the least amount of support needed while maintaining safety and confidence. The study then compared upper limb loading, lower limb loading ability, and walking performance among participants with different levels of optimal walking ability. The study suggests that the ULLD could be beneficial for prescribing walking devices and monitoring changes in walking ability among individuals with SCI, potentially leading to better rehabilitation strategies.

Study Duration

June 2018 to August 2019

Participants

49 ambulatory participants with SCI who used a walking device daily

Evidence Level

Not specified

Key Findings

1
Approximately one-third of the participants (31%) could improve their walking ability from their current state, with some even able to walk without any walking device.
2
The amount of upper limb loading, lower limb loading ability, and walking performance differed significantly among the groups with different optimal walking abilities.
3
There was a negative correlation between upper limb loading and both lower limb loading ability and walking performance, meaning that as upper limb loading decreased, lower limb loading and walking performance improved.

Research Summary

The study developed an upper limb loading device (ULLD) and assessed its utility in determining the optimal walking ability of ambulatory individuals with spinal cord injury (SCI). The findings indicated that a significant portion of participants could improve their walking ability, and the ULLD showed potential for guiding walking device prescription and monitoring changes in walking ability. The amount of upper limb loading was negatively correlated with lower limb loading ability and walking performance, suggesting that reducing upper limb support can improve walking ability in these individuals.

Practical Implications

Improved Walking Device Prescription

The ULLD can be used to objectively assess the amount of upper limb loading required by individuals with SCI, leading to more appropriate walking device prescriptions.

Enhanced Rehabilitation Monitoring

The ULLD allows for monitoring changes in walking ability over time, enabling clinicians to adjust rehabilitation strategies as needed.

Optimized Walking Performance

By minimizing reliance on upper limb support, individuals with SCI can potentially improve their lower limb loading ability and overall walking performance, leading to more efficient and functional ambulation.

Study Limitations

1
The study primarily included participants with relatively good walking abilities, which may limit the generalizability of the findings to those with more severe impairments.
2
The cross-sectional design of the study prevents establishing causal relationships between upper limb loading, lower limb loading, and walking performance.
3
There is a need for further research to determine cut-off scores for optimal walking ability using the ULLD specifically for individuals with SCI.

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