Feasibility and Short-term Functional Outcomes of Early Gait Training within 14 days after Thoracic Myelopathy...

This study examined the feasibility, short-term safety, and changes in objective mobility measures associated with initiating gait training between postoperative day (POD) 2 and POD 4 and completing it by POD 14 following surgery for thoracic myelopathy.

This retrospective, single-arm cohort study included 11 patients with thoracic myelopathy and preoperative gait impairments. Individualized gait training combined recumbent cycling and treadmill walking (~40 min/session, 3-5 times/week) at a "somewhat hard" intensity on the modified Borg scale (rating: 6). Primary outcomes were walking speed and step length on the 10-m Walk Test. Secondary outcomes included time and step count from the Timed Up-and-Go Test (TUG), the Japan Orthopaedic Association lower-extremity motor function score (JOA-LE), static balance, muscle strength, and sensory function. Assessments were performed preoperatively and on POD 14.

Walking speed (median change 0.25 m/s, P = 0.029) and step length (median change 0.05 m, P = 0.009) improved significantly. TUG results also improved for completion time (median change -3.03 s, P = 0.007) and step count (median change -3 steps, P = 0.046). Standing balance improved, with nine patients achieving independence in the Romberg position with eyes closed (P = 0.029). No notable changes were observed in JOA-LE, muscle strength, or sensory function. No adverse events occurred.

Early, device-assisted gait training initiated within POD 4 was feasible and safe, and it was associated with short-term improvements in objective mobility measures. Controlled trials are warranted to confirm these findings.