Retraining walking adaptability following incomplete spinal cord injury

Area of Science:

• Neurorehabilitation
• Motor control
• Spinal cord injury research

Background:

• Functional walking relies on gait adaptability to environmental demands.
• Current rehabilitation for incomplete spinal cord injury (ISCI) focuses on repetitive stepping (Basic-LT).
• Gait adaptability training has not been established for ISCI but may improve walking skills.

Purpose of the Study:

• To describe and assess the feasibility of a gait adaptability retraining approach (Adapt-LT) for individuals with ISCI.
• To compare the dose and intensity of Adapt-LT to Basic-LT.
• To evaluate the potential of Adapt-LT to enhance walking function.

Main Methods:

• A case series involving three individuals with ISCI (AIS C or D) who completed 3 weeks of Basic-LT and 3 weeks of Adapt-LT (15 sessions each).
• Interventions included treadmill training with body weight support and overground practice.
• Adapt-LT focused on speed changes, obstacle negotiation, and backward walking; training parameters were compared.

Main Results:

• Adapt-LT was feasible to administer with similar dosage and intensity compared to Basic-LT.
• Participants demonstrated improvements in walking function and balance after both training types.
• Training parameters like step counts, speeds, and perceived exertion were comparable between interventions.

Conclusions:

• Rehabilitation incorporating stepping practice with adaptability tasks is feasible for individuals with ISCI.
• Adapt-LT shows promise for improving walking function and balance in ISCI.
• Further research is required to establish the efficacy of Adapt-LT.