Effects of aerobic exercise training on fitness and walking-related outcomes in ambulatory individuals with chronic incomplete spinal cord injury

Abstract

Study DesignSingle group, pretest-posttest study.ObjectivesTo determine the effects of a non-task-specific, voluntary, progressive aerobic exercise training (AET) intervention on fitness and walking-related outcomes in ambulatory adults with chronic motor-incomplete SCI.SettingRehabilitation research center.MethodsTen ambulatory individuals (50% female; 57.94 ± 9.33 years old; 11.11 ± 9.66 years post injury) completed voluntary, progressive moderate-to-vigorous intensity AET on a recumbent stepper three days per week for six weeks. The primary outcome measures were aerobic capacity (VO2peak) and self-selected overground walking speed (OGWS). Secondary outcome measures included: walking economy, six-minute walk test (6MWT), daily step counts, Walking Index for Spinal Cord Injury (WISCI-II), Dynamic Gait Index (DGI), and Berg Balance Scale (BBS).ResultsNine participants completed all testing and training. Significant improvements in aerobic capacity (P=0.011), OGWS (P=0.023), the percentage of VO2peak utilized while walking at self-selected speed (P=0.03), and daily step counts (P=0.025) resulted following training.ConclusionsThe results indicate that total-body, voluntary, progressive AET is safe, feasible, and effective for improving aerobic capacity, walking speed, and select walking-related outcomes in an exclusively ambulatory SCI sample. This study suggests the potential for non-task-specific aerobic exercise to improve walking following incomplete SCI and builds a foundation for further investigation aimed at the development of exercise based rehabilitation strategies to target functionally limiting impairments in ambulatory individuals with chronic SCI.

High-Intensity Variable Stepping Training in Patients With Motor Incomplete Spinal Cord Injury: A Case Series

“…During graded exercise testing, both peak TM speeds and VO 2 peak increased consistently across participants. The average gains of 2-6 ml/kg/min in VO 2 peak and 0.1-0.3 m/s in peak TM speeds approximate changes observed in participants with chronic stroke or SCI following higher intensity TM training [40][41][42] , and gains in participants with iSCI following lower intensity, recumbent stepping training 43 . While the data suggest some functional benefits of high intensity training, kinematic analyses were utilized to provide some insight into strategies used to increase walking speed.…”

Does Neuromuscular Electrical Stimulation Therapy Increase Voluntary Muscle Strength After Spinal Cord Injury? A Systematic Review

“…These morphological changes promote a reduction in the capacity to generate torque and strength, a common problem in people with SCI. [1][2][3] The ability to generate strength is an important prerequisite for an individual to carry out his/her daily living activities (DLA), maintaining his/her function and independence. [4][5][6] There are currently a range of different treatments used in clinical practice to increase strength in people with SCI, such as progressive resistance training (PRT), robotic gait training, cycle ergometer, and neuromuscular electrical stimulation (NMES).…”

Impact of Perturbation-Based Balance Training on Functional Outcomes in a Patient with Chronic Incomplete Spinal Cord Injury: A Case Report

“…Foster,et al found improvements in balance, balance confidence, and functional mobility measured by the TUG in the incomplete SCI population, but were a result of performing backward walking training compared to the PBT performed in this case 35 report. DiPiro,et al also found a similar improvement in aerobic capacity in those with 36 incomplete SCI and Hicks,et al found the same in a meta-analysis of those with complete 20 injuries, but both results were after performing specific, aerobic training.…”