Article

About 75% of persons with
ASIA (American Spinal Injury Association)
Impairment Scale C and D incomplete spinal cord injury (SCI) achieve walking
ability. OBJECTIVE: To compare a walking reeducation program using Lokomat with
conventional overground training among individuals with incomplete SCI of both
traumatic and nontraumatic etiology. METHODS:
A total of 80 participants from 3
to 6 months after onset admitted to 1 site for rehabilitation were included in a
single-blind randomized clinical trial of 2 parallel groups, with blind
evaluation by independent observers. Patients received 40 walking reeducation
sessions of equal time using a Lokomat program with overground practice or
overground mobility therapy alone. Primary measurements of outcome were walking
speed and the Walking Index for Spinal Cord Injury (WISCI II). Secondary outcomes
were the 6-minute walk test, locomotor section of the Functional Independence
Measure, Lower Extremity Motor Score (LEMS), Ashworth Scale, and Visual Analog
Scale for pain. RESULTS: No significant differences were found at entry between
treatment groups. Walking speed for Lokomat (0.4m/s [0.6-0.2]) and overground
therapy (0.3m/s [0.5-0.2]) groups did not differ. The WISCI II for the Lokomat group (16 [8.5-19]) was better than for overground therapy
(9 [8-16]). The
6-minute walk test and LEMS displayed significant differences in favor of Lokomat
therapy but were not corrected for multiple comparisons. CONCLUSIONS:
Robotic-assisted training was equivalent to conventional walk training in
patients with a variety of nonprogressive spinal cord pathologies for walking
speed, but the need for orthotics and assistive devices was reduced, perhaps
because of greater leg strength in the robotic group.

Langue : ANGLAIS