Spinal cord injury: prognosis for ambulation based on quadriceps recovery

Abstract

The purpose of this study was to determine if early recovery of quadricep muscle strength post spinal cord injury (SCI) is a useful predictor of future ambulation. Seventeen C4-T10 motor incomplete (Frankel C) spinal cord injured patients adimitted to our center between March 1988 and April 1990 were examined within 72 hours to one week post injury. All patients had initial quadricep strengths � 2/5 in both legs. Strength in the strongest quadricep was followed prospectively at intervals from admission to one year post injury. Recovery time to a > 3/5 quadricep was established for each patient. Patients were categorized into 2 groups: FA (n = 11) were those patients who achieved functional ambulation and NA (n = 6) were those subjects who were nonambu lators. Functional ambulators were defined as those patients who were able to walk in the household and/or the community while non ambulators were those who either did not ambulate or did so only for exercise. All patients (n = 9) who achieved a > 3/5 quadricep by 2 months post SCI became functional ambulators whereas in the group of 8 patients who did not achieve a > 3/5 by 2 months, only 2 became functional ambulators. This result was found to be significant using a point-by-serial correlation with p < 0.05. In conclusion, motor incom plete spinal cord injured patients who recovered to a > 3/5 quadricep strength by 2 months post injury had an excellent prognosis for subsequent ambulation by 6 months post injury.

Level walking and ambulatory capacity in persons with incomplete spinal cord injury: relationship with muscle strength

“…Contrary to expectations, the knee extensor strength was not related to ambulatory capacity. Other studies 8,12 have previously reported the knee extensor strength to be associated with ambulatory capacity. Both Crozier et al 8 and Hussey and Stauffer 12 found that a minimum of grade 3 knee extensor strength on the less affected side was required for community ambulation (ie able to walk in-and outdoors).…”

Disability and determinants of gait performance in tropical spastic paraparesis/HTLV-I associated myelopathy (HAM/TSP)

“…It is considered essential for functional ambulation of traumatic spinal cord injury patients. 23,24 The importance of plantar flexor muscles, however, has been minimized. 25 The role of this muscle group in the gait cycle, being active in weight acceptance (loading response and pre-swing phase), is important to progress and stability.…”

Electrophysiological recordings in patients with spinal cord injury: significance for predicting outcome

“…31 For studying the prognostic value of electrophysiological recordings a gradation of the functional outcome of ambulatory capacity into four functionally relevant categories was applied. 32,33 (a) full ambulatory capacity=no restriction in the activities of daily living and employment due to lower limb de®cit; (b) functional ambulatory capacity=walking daily over a distance of more than 500 m without personal assistance. The use of one or two sticks and/or braces is allowed.…”