Article

OBJECTIVE: To evaluate relationships among ambulation and balance outcome
measures over time for incomplete spinal cord injury (SCI) after locomotor
training, in order to facilitate the selection of effective and sensitive
rehabilitation outcomes. DESIGN: Prospective observational cohort. SETTING:
Outpatient rehabilitation centers (N=7) from the Christopher and Dana Reeve
Foundation NeuroRecovery Network. PARTICIPANTS: Patients with incomplete SCI
(N=182) American Spinal Injury Association Impairment Scale level C (n=61) and D
(n=121). INTERVENTIONS: Intensive locomotor training, including step training
using body weight support and manual facilitation on a treadmill followed by
overground assessment and community integration. MAIN OUTCOME MEASURES:
Six-minute and 10-meter walk tests, Berg Balance Scale, Modified Functional
Reach, and Neuromuscular Recovery Scale collected at enrollment, approximately
every 20 sessions, and on discharge. RESULTS: Walking and standing balance
measures for all participants were strongly correlated (r>/=.83 for all pairwise
outcome correlations), standing and sitting balance measures were not highly
correlated (r</=.48 for all pairwise outcome correlations), and walking measures
were weakly related to sitting balance. The strength of relationships among
outcome measures varied with functional status. Correlations among
evaluation-to-evaluation changes were markedly reduced from performance
correlations. Walk tests, when conducted with different assistive devices, were
strongly correlated but had substantial variability in performance. CONCLUSIONS:
These results cumulatively suggest that changes in walking and balance measures
reflect different aspects of recovery and are highly influenced by functional
status and the utilization of assistive devices. These factors should be
carefully considered when assessing clinical progress and designing clinical
trials for rehabilitation.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS