Shepherd Center, Crawford Research Institute, Atlanta, GA.
Shepherd Center, Crawford Research Institute, Atlanta, GA; Georgia Institute of Technology, Program in Applied Physiology, Atlanta, GA; Emory University School of Medicine, Department of Rehabilitation Medicine, Atlanta, GA.
Arch Phys Med Rehabil. 2024 Jul;105(7):1289-1298. doi: 10.1016/j.apmr.2024.02.725. Epub 2024 Mar 2.
To quantify spatiotemporal coordination during overground walking among persons with motor-incomplete spinal cord injury (PwMISCI) by calculating the step length (SL)/step frequency (SF) ratio (ie, the Walk Ratio [WR]) and to examine the effects of motor skill training (MST) on the relationship between changes in these parameters and walking speed (WS).
Between-day exploratory analysis.
Research laboratory in a rehabilitation hospital PARTICIPANTS: PwMISCI (N=26).
3-day high-velocity MST.
Overground WS, SL, SF, and WR measured during the 10-Meter Walk Test.
Among the full sample, MST was associated with increases in WS, SL, SF, and a decrease in the WR. Relative change in WS and SF was higher among slow (ΔWS=↑46%, ΔSF=↑28%) vs fast (ΔWS=↑16%, ΔSF=↑8%) walkers. Change in the WR differed between groups (slow: ΔWR=↓10%; fast: ΔWR=0%). Twenty-six percent of the variability observed in ΔWR among slow walkers could be explained by ΔSF, while ΔSL did not contribute to ΔWR. Among fast walkers, ΔSL accounted for more than twice the observed ΔWR (43%) compared to ΔSF (15%).
On the whole, WR values among PwMISCI are higher than previous reports in other neurologic populations; however, values among fast walkers were comparable to noninjured adults. Slow walkers demonstrated greater variability in the WR, with higher values associated with slower WS. Following MST, increases in WS coincided with a decrease in the WR among slow walkers, mediated primarily through an effect on SF. This finding may point to a specific mechanism by which MST facilitates improvements in WS among PwMISCI with greater mobility deficits.
通过计算步长（SL）/步频（SF）比值（即行走比[WR]），量化运动功能不完全性脊髓损伤（PwMISCI）患者在地面行走时的时空协调性，并探讨运动技能训练（MST）对这些参数变化与行走速度（WS）之间关系的影响。
基于日的探索性分析。
康复医院的研究实验室
PwMISCI（N=26）。
为期 3 天的高速 MST。
10 米步行测试中测量的地面 WS、SL、SF 和 WR。
在全样本中，MST 与 WS、SL、SF 的增加以及 WR 的降低有关。在较慢（ΔWS=↑46%，ΔSF=↑28%）和较快（ΔWS=↑16%，ΔSF=↑8%）步行者中，WS 和 SF 的相对变化更高。WR 的变化在两组之间存在差异（较慢：ΔWR=↓10%；较快：ΔWR=0%）。在较慢步行者中，WR 的变化有 26%可以用ΔSF 来解释，而ΔSL 对 WR 的变化没有贡献。在较快步行者中，ΔSL 解释了观察到的 WR 变化的两倍多（43%），而ΔSF 仅占 15%。
总的来说，PwMISCI 的 WR 值高于其他神经病变人群的先前报告，但快步行者的 WR 值与未受伤的成年人相当。慢步行者的 WR 变化更为多变，WR 值较高与 WS 较慢相关。MST 后，WS 的增加与较慢步行者的 WR 降低相关，这主要是通过对 SF 的影响介导的。这一发现可能表明 MST 通过特定机制促进了运动功能障碍较大的 PwMISCI 的 WS 改善。
