Article

People with incomplete spinal cord injury (iSCI) expend considerable energy to
walk, which can lead to rapid fatigue and limit community ambulation. Selecting
locomotor patterns that enhance lateral stability may contribute to this
population's elevated cost of transport. The goal of the current study was to
quantify the metabolic energy demands of maintaining lateral stability during
gait in people with iSCI. To quantify this metabolic cost, we observed ten
individuals with iSCI walking with and without external lateral stabilization. We
hypothesized that with external lateral stabilization, people with iSCI would
adapt their gait by decreasing step width, which would correspond with a
substantial decrease in cost of transport. Our findings support this hypothesis.
Subjects significantly (p<0.05) decreased step width by 22%, step width
variability by 18%, and minimum lateral margin of stability by 25% when they
walked with external lateral stabilization compared to unassisted walking.
Metabolic cost of transport also decreased significantly (p<0.05) by 10% with
external lateral stabilization. These findings suggest that this population is
capable of adapting their gait to meet changing demands placed on balance. The
percent reduction in cost of transport when walking with external lateral
stabilization was strongly correlated with functional impairment level as
assessed by subjects' scores on the Berg Balance Scale (r=0.778) and lower
extremity motor score (r=0.728). These relationships suggest that as functional
balance and strength decrease, the amount of metabolic energy used to maintain
lateral stability during gait will increase.
CI - Published by Elsevier B.V.

Langue : ANGLAIS