St. Francis Hospital, Evanston, Illinois, USA.
Phys Ther. 2010 Feb;90(2):224-35. doi: 10.2522/ptj.20090064. Epub 2009 Dec 18.
In individuals with motor incomplete spinal cord injury (SCI), ambulatory function determined in the clinical setting is related to specific measures of body structure and function and activity limitations, although few studies have quantified the relationship of these variables with daily stepping (steps/day).
The aim of this study was to quantify daily stepping in ambulatory individuals with SCI and its relationship with clinical walking performance measures and specific demographics, impairments, and activity limitations.
A cross-sectional study was performed to estimate relationships among clinical variables to daily stepping in self-identified community versus non-community (household) walkers.
Average daily stepping was determined in 50 people with chronic, motor incomplete SCI. Data for clinical and self-report measures of walking performance also were collected, and their associations with daily stepping were analyzed using correlation and receiver operating characteristic (ROC) analyses. Relationships between daily stepping and the measures of demographics, impairments, and activity limitations were identified using correlation and regression analyses.
The ROC analyses revealed a significant discriminative ability between self-reported community and non-community walkers using clinical gait measures and daily stepping. Stepping activity generally was low throughout the sample tested, however, with an average of approximately 2,600 steps/day. Knee extension strength (force-generating capacity) and static balance were the primary variables related to daily stepping, with metabolic efficiency and capacity and balance confidence contributing to a lesser extent.
The small sample size and use of specific impairment-related measures were potential limitations of the study.
Daily stepping is extremely limited in individuals with incomplete SCI, with a potentially substantial contribution of impairments in knee extension strength and balance.
在运动功能不完全性脊髓损伤（SCI）患者中，临床评估的步行功能与身体结构和功能的具体指标以及活动受限相关，尽管已有少数研究量化了这些变量与日常步数（steps/day）的关系。
本研究旨在量化有步行能力的 SCI 患者的日常步数及其与临床步行表现测量指标以及特定人口统计学、损伤和活动受限的关系。
本研究为横截面研究，用于评估社区和非社区（家庭）行走的自我识别者的临床变量与日常步数之间的关系。
对 50 名患有慢性、运动功能不完全性 SCI 的患者进行平均日常步数的测定。还收集了临床和自我报告的步行表现测量数据，并使用相关和接收者操作特征（ROC）分析来分析它们与日常步数的关系。使用相关和回归分析确定了日常步数与人口统计学、损伤和活动受限测量之间的关系。
ROC 分析显示，使用临床步态测量和日常步数可以很好地区分自我报告的社区和非社区行走者。然而，整个测试样本的步频活动普遍较低，平均约为 2600 步/天。膝关节伸展力量（产生力量的能力）和静态平衡是与日常步数最相关的主要变量，而代谢效率和容量以及平衡信心的贡献较小。
样本量小和使用特定的损伤相关测量可能是本研究的局限性。
不完全性 SCI 患者的日常步数非常有限，膝关节伸展力量和平衡的损伤可能会有较大的影响。
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