Kumprou Makamas, Amatachaya Pipatana, Sooknuan Thanat, Thaweewannakij Thiwabhorn, Amatachaya Sugalya
a School of Physical Therapy, Faculty of Associated Medical Sciences , Khon Kaen University , Khon Kaen , Thailand.
b Improvement of Physical Performance and Quality of Life (IPQ) Research Group , Khon Kaen University , Khon Kaen , Thailand.
Disabil Rehabil. 2018 Apr;40(7):836-841. doi: 10.1080/09638288.2016.1277398. Epub 2017 Jan 17.
To assess and compare the levels of walking symmetry in ambulatory participants with spinal cord injury (SCI) who had different degrees of lesion severity, levels of walking ability, and fall history. In addition, the study explored the relationship between the levels of walking symmetry and variables related to the ability of well-controlled walking of the participants.
Cross-sectional study.
Sixty-six eligible participants were assessed and interviewed for levels of walking symmetry, walking speed, functional endurance, symmetrical lower limb support ability, balance control, and fall history over the last 6 months.
Participants walked asymmetrically (85%) similar to those with unilateral impairments (i.e., patients with stroke and amputee, 79-93%). The levels of walking symmetry were significantly correlated to walking speed, functional endurance and balance ability of the participants (p < 0.05). The problem and correlation were particularly apparent in those with the history of multiple falls (79%, r = 0.613-0.765, p < 0.005) Conclusions: The findings confirm problems of asymmetrical walking and the importance of walking symmetry for the ability of well-controlled walking and a risk of multiple falls in ambulatory participants with SCI. Therefore, apart from the levels of independence, the improvement of walking symmetry is crucial for these individuals. Implications for Rehabilitation: Ambulatory individuals with spinal cord injury walked asymmetrically at the same level as those with unilateral impairments such as patients with stroke and amputee. Their levels of walking symmetry were significantly related to the ability of well-controlled walking, particularly in those with the history of multiple falls. The finding confirmed the importance of walking symmetry as a crucial parameter to detect walking improvement and fall risk reduction. Apart from the levels of independence, rehabilitation professionals also need to emphasize on the improvement of symmetrical walking for these patients.
评估并比较不同损伤严重程度、步行能力水平及跌倒史的脊髓损伤（SCI）门诊患者的步行对称性水平。此外，本研究还探讨了步行对称性水平与患者良好控制步行能力相关变量之间的关系。
横断面研究。
对66名符合条件的参与者进行评估和访谈，了解其步行对称性水平、步行速度、功能耐力、双侧下肢支撑能力、平衡控制以及过去6个月内的跌倒史。
参与者存在不对称步行（85%），与单侧功能障碍者（即中风患者和截肢者，79 - 93%）相似。步行对称性水平与参与者的步行速度、功能耐力和平衡能力显著相关（p < 0.05）。在有多次跌倒史的参与者中，该问题及相关性尤为明显（79%，r = 0.613 - 0.765，p < 0.005）。结论：研究结果证实了SCI门诊患者存在不对称步行问题，以及步行对称性对于良好控制步行能力和多次跌倒风险的重要性。因此，除了独立水平外，改善步行对称性对这些个体至关重要。康复意义：脊髓损伤的门诊患者步行不对称程度与中风患者和截肢者等单侧功能障碍者相同。他们的步行对称性水平与良好控制步行的能力显著相关，尤其是在有多次跌倒史的患者中。这一发现证实了步行对称性作为检测步行改善和降低跌倒风险的关键参数的重要性。除了独立水平外，康复专业人员还需要强调改善这些患者的对称步行。
