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Overground Locomotor Training in Spinal Cord Injury: A Performance-Based Framework
Jared M Gollie1, Andrew A Guccione1
1Department of Rehabilitation Science, George Mason University College of Health and Human Services, Fairfax, Virginia.
Topics in Spinal Cord Injury Rehabilitation
|January 18, 2018
Summary
Overground locomotor training (OLT) shows promise for improving walking speed and economy in individuals with spinal cord injury (SCI). This new framework guides OLT program design for better recovery outcomes.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Motor Control
Background:
- Locomotor training (LT) is a primary intervention for improving walking post-spinal cord injury (SCI).
- Advancements in LT require integrative models considering multiple physiological systems for walking recovery.
- Current LT approaches need refinement to optimize functional gains in SCI individuals.
Purpose of the Study:
- To introduce a performance-based framework for overground locomotor training (OLT).
- To outline adaptation and motor learning principles for designing OLT programs.
- To present a sample OLT program grounded in the proposed framework.
Main Methods:
- Study included individuals with chronic motor-incomplete SCI (AIS C/D).
- Participants underwent 24 OLT sessions (90 minutes each) over 12 weeks.
- Outcome measures: overground walking speed, walking economy, oxygen uptake, and muscle oxygen extraction (NIRS).
Main Results:
- OLT demonstrated potential to enhance overground walking speed and improve walking economy.
- Accelerated oxygen delivery and utilization during rest-to-work transitions were observed.
- Reduced skeletal muscle oxygen extraction requirements during walking were noted.
Conclusions:
- The proposed OLT framework provides a template for clinical and research applications.
- Further research is needed to optimize OLT principles (specificity, overload, variation) for maximizing function in SCI.
- This approach aims to improve health and quality of life for individuals with SCI.
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