Training to achieve over ground walking after spinal cord injury: A review of who, what, when, and how

This review explores effective methods for retraining walking in adults with spinal cord injuries (SCI) to achieve over ground walking. The authors aimed to provide clinicians with the best evidence and identify gaps in knowledge for future research. The review considers studies on walking retraining, focusing on client characteristics and training methods that lead to independent over ground walking (not requiring manual assistance, electrical stimulation, or extensive bracing). The authors emphasize that intensive training using walking as the main activity, with partial or no assistance, is crucial for success, regardless of whether it's on a treadmill or over ground.

• 1
  Individuals with motor incomplete SCI (ASIA Impairment Scale C and D) are most likely to regain walking over ground.
• 2
  Effective training methods involve a substantial component of walking, and partial assistance is more effective than total assistance.
• 3
  Earlier training, both in the subacute and chronic phases after injury, leads to superior results, though individuals with chronic injuries can still improve.