Article

OBJECTIVE: To identify the physical
impairments and walking function required for community ambulation in patients
with cervical incomplete spinal cord injury (ISCI).Setting:Chubu Rosai Hospital,
Nagoya, Japan. METHODS: Forty patients with cervical ISCI (mean age: 49.9 years,
American Spinal Injury Association Impairment Scale D) were included. The primary
outcome measure was community ambulation based on Spinal Cord Independence
Measure outdoor scores for a distance of >480 m. We measured the upper- and
lower-extremity motor scores (UEMS and LEMS), sensory and spasticity. The walking
tests included 10 m of walking at a comfortable- and maximum-walking speed (CWS
and MWS; m s(-1)), 6 min walking test (6 MWT; m) and the walking index for spinal
cord injury II (WISCI II). Multivariate logistic regression models were used to
assess the physical impairments associated with community ambulation. Receiver
operating characteristic curves were analyzed to determine the cutoff points for
physical impairment and walking function. RESULT: The LEMS (beta coefficient
(beta)=0.71) and UEMS (beta=0.41) were independently associated with community
ambulation in patients with cervical ISCI. The cutoff points of the LEMS, UEMS,
CWS, MWS, 6MWT and WISCI II were 41.5, 36.5, 1.00 m s(-1), 1.32 m s(-1), 472.5 m
and 17.5, respectively, which suggests moderate to high accuracy. CONCLUSION: The
LEMS and UEMS were the most important factors affecting community ambulation in
patients with cervical ISCI. The cutoff points of the walking function tests were
highly accurate; therefore, these points can serve as targets for walking
training in the future.

Langue : ANGLAIS