Article

The prognosis for further recovery of motor function 2 years after
complete spinal cord injury is poor. This case report describes recovery of
walking function in an a 33-year old man two years post T7 spinal cord injury
American Spinal Injury Association Impairment Scale A following intensive
physical therapy and robotic locomotor training.
DESIGN: Case report. METHODS: The subject engaged in an intensive clinic-based physical therapy program and
research-based robotic locomotor training study over a 7-month period. Physical
therapy was initiated 4 months prior to entry into the research study, and
targeted trunk control, upper extremity strength, and upright mobility. On
initial entry into the robotic locomotor training study the subject's AIS A
classification was substantiated. Initial, interim, and follow-up tests of
sensation, strength, sitting balance, spasticity, and mobility were performed.
RESULTS: Lower extremity motor scores improved from 0/50 to 4/50, bilateral hip
flexors increased from grade 0/5 to 2/5, warranting injury re-classification from
American Spinal Injury Association Impairment Scale A to C. Intensive physical
therapy combined with robotic locomotor training was associated with restoration
of short distance walking function with lower extremity braces and a walker.
CONCLUSION: To our knowledge, this is the first report of an individual with
chronic spinal cord injury American Spinal Injury Association Impairment Scale A
improving in over-ground walking ability following intensive physical therapy and
robotic locomotor training. The presence of a neurophysiologically discomplete
lesion probably permitted training of operational neural pathways and enabled the
development of useful voluntary movement.

Langue : ANGLAIS