Protas E J, Holmes S A, Qureshy H, Johnson A, Lee D, Sherwood A M
School of Physical Therapy, Texas Woman's University, Houston 77030-2897, USA.
Arch Phys Med Rehabil. 2001 Jun;82(6):825-31. doi: 10.1053/apmr.2001.23198.
To conduct a pilot study of weight-supported ambulation training after incomplete spinal cord injury (SCI), and to assess its safety.
Quasiexperimental, repeated measures, single group.
Veterans Affairs medical center.
Three subjects with incomplete, chronic, thoracic SCIs; 2 classified as D on the American Spinal Injury Association (ASIA) impairment scale and 1 as ASIA impairment scale C.
Subjects participated in 12 weeks of training assisted by 2 physical therapists. The training consisted of walking on a treadmill while supported by a harness and a pneumatic suspension device. Support started at 40% of body weight and a treadmill speed of.16kmph, and progressed by reducing support and increasing treadmill speed and continuous treadmill walking time up to 20 minutes. Training was conducted for 1 hour per day, 5 days per week for 3 months. Treadmill walking occurred for 20 minutes during the sessions.
Gait function (speed, endurance, walking status, use of assistive device and orthotics); oxygen costs of walking; brain motor control assessment; self-report indices; ASIA classification; muscle function test; and safety.
All 3 subjects increased gait speed (.118m/s initially to.318m/s after training 12wk), and gait endurance (20.3m/5min initially to 63.5m/5min). The oxygen costs decreased from 1.96 to 1.33mL x kg(-1) x m(-1) after 12 weeks of training.
This pilot study suggests that supported treadmill ambulation training can improve gait for individuals with incomplete SCIs by using objective gait measures. The self-report indices used have promise as patient-centered outcome measures of this new form of gait training. A larger, controlled study of this technique is warranted.
对不完全性脊髓损伤(SCI)后体重支持下的步行训练进行一项初步研究,并评估其安全性。
准实验性、重复测量、单组研究。
退伍军人事务医疗中心。
3例不完全性慢性胸段SCI患者;2例根据美国脊髓损伤协会(ASIA)损伤量表分类为D级,1例为ASIA损伤量表C级。
受试者在2名物理治疗师的协助下参加为期12周的训练。训练包括在跑步机上行走,同时由吊带和气动悬挂装置提供支持。支持起始重量为体重的40%,跑步机速度为0.16千米/小时,随后通过减少支持、增加跑步机速度以及延长跑步机连续行走时间至20分钟来逐步推进。训练每天进行1小时,每周5天,共3个月。每次训练中跑步机行走时间为20分钟。
步态功能(速度、耐力、行走状态、辅助装置和矫形器的使用情况);步行的氧耗量;脑运动控制评估;自我报告指标;ASIA分级;肌肉功能测试;以及安全性。
所有3例受试者的步态速度均有所提高(最初为0.118米/秒,训练12周后为0.318米/秒),步态耐力也有所提高(最初为20.3米/5分钟,训练后为63.5米/5分钟)。经过12周训练后,氧耗量从1.96降至1.33毫升×千克⁻¹×米⁻¹。
这项初步研究表明,通过使用客观的步态测量方法,体重支持下的跑步机步行训练可以改善不完全性SCI患者的步态。所使用的自我报告指标有望作为这种新型步态训练以患者为中心的结局指标。有必要对该技术进行更大规模的对照研究。