Background: The reduction in physical activity that accompanies spinal cord injury (SCI) contributes to the development of secondary health concerns. Research has explored potential strategies to enhance the recovery of walking and lessen the impact of physical disability following SCI, but further work is needed to identify determinants of community walking activity in this population. Objectives: To quantify relationships among lower extremity strength (LES), preferred walking speed (PWS), and daily step activity (DSA) in adults with incomplete SCI (iSCI) and determine the extent to which LES and PWS predict DSA in persons with iSCI. Methods: Participants were 21 adults (age range, 21 to 62 years; AIS levels C and D) with iSCI. Maximal values of hip abduction, flexion, and extension, knee flexion and extension, and ankle dorsiflexion and plantar flexion were measured using handheld dynamometry and were summed to determine LES. PWS was calculated using a photoelectric cell-based timing system, and participants were fitted with activity monitors to measure DSA in a natural setting. Results: Statistically significant (P < .05) correlations of moderate to high magnitude (.74 to .87) were observed among LES, PWS, and DSA. Multiple regression analysis revealed that LES and PWS accounted for 83% (adjusted R2) of the variation in DSA (P < .001). Conclusion: A significant proportion of the explained variance in DSA can be predicted from knowledge of LES and PWS in adults with iSCI. These findings suggest that future efforts to improve community walking behavior following SCI should be directed toward increasing LES and PWS.
Saraf P, Rafferty M, Moore J, et al. Daily stepping in individuals with motor incomplete spinal cord injury. Phys Ther. 2010;90(2):224-240.
,
Daily stepping in individuals with motor incomplete spinal cord injury
, Phys Ther.
, vol. 90
(pg. 224
-240
) Botos M, Gericke C. Ambulatory capacity in cerebral palsy: prognostic criteria and consequences for intervention. Dev Med Child Neurol. 2003;45:786-790.
,
Ambulatory capacity in cerebral palsy: prognostic criteria and consequences for intervention
, Dev Med Child Neurol.
, vol. 45
(pg. 786
-790
) Lavis T, Scelza W, Bockenek W. Cardiovascular health and fitness in persons with spinal cord injury. Phys Med Rehabil Clin North Am. 2007;18:317-331.
,
Cardiovascular health and fitness in persons with spinal cord injury
, Phys Med Rehabil Clin North Am.
, vol. 18
(pg. 317
-331
) Ditunno J, Scivoletto G. Clinical relevance of gait research applied to clinical trials in spinal cord injury. Brain Res Bull. 2009;78:35-42.
,
Clinical relevance of gait research applied to clinical trials in spinal cord injury
, Brain Res Bull.
, vol. 78
(pg. 35
-42
) Shah P, Stevens J, Gregory C, et al. Lower-extremity muscle cross-sectional area after incomplete spinal cord injury. Arch Phys Med Rehabil 2006;87(6):772-778.
,
Lower-extremity muscle cross-sectional area after incomplete spinal cord injury
, Arch Phys Med Rehabil
, vol. 87
(pg. 772
-778
) Kim, C, Eng J, Whittaker M. Level walking and ambulatory capacity in persons with incomplete spinal cord injury: relationship with muscle strength. Spinal Cord. 2004;42:156-162.
,
Level walking and ambulatory capacity in persons with incomplete spinal cord injury: relationship with muscle strength
, Spinal Cord.
, vol. 42
(pg. 156
-162
) Riddle D, Finucaine S, Rothstein J, Walker M. Intrasession and intersession reliability of hand-held dynamometer measurements taken on brain damaged patients. Phys Ther. 1989;69:182-194.
,
Intrasession and intersession reliability of hand-held dynamometer measurements taken on brain damaged patients
, Phys Ther.
, vol. 69
(pg. 182
-194
) Nollet F, Beelen A. Strength assessment in postpolio syndrome: validity of a hand-held dynamometer in detecting change. Arch Phys Med Rehabil. 1999;80(10):1316-1323.
,
Strength assessment in postpolio syndrome: validity of a hand-held dynamometer in detecting change
, Arch Phys Med Rehabil.
, vol. 80
(pg. 1316
-1323
) Bowden M, Behrman A. Step activity monitor: accuracy and test-retest reliability in persons with incomplete spinal cord injury. J Rehabil Res Dev. 2007;44(3):355-362.
,
Step activity monitor: accuracy and test-retest reliability in persons with incomplete spinal cord injury
, J Rehabil Res Dev.
, vol. 44
(pg. 355
-362
) Wiley M, Damiano D. Lower-extremity strength profiles in spastic cerebral palsy. Dev Med Child Neurol. 1998;40:100-107.
,
Lower-extremity strength profiles in spastic cerebral palsy
, Dev Med Child Neurol.
, vol. 40
(pg. 100
-107
) Dobkin B, Apple D, Barbeau H, et al. Weight-supported treadmill vs over-ground training for walking after acute incomplete spinal cord injury. Neurology. 2006;66(2):484-493.
,
Weight-supported treadmill vs over-ground training for walking after acute incomplete spinal cord injury
, Neurology.
, vol. 66
(pg. 484
-493
) Geisler F, Dorsey F, Coleman W. Recovery of motor function after spinal cord injury – a randomized placebo-controlled trail with GM-1 ganglioside. New Engl J Med. 1991;324(26):1829-1838.
,
Recovery of motor function after spinal cord injury – a randomized placebo-controlled trail with GM-1 ganglioside
, New Engl J Med.
, vol. 324
(pg. 1829
-1838
) Lapointe R, Lajoie Y, Serresse O, Barbeau H. Functional community ambulation requirements in incomplete spinal cord injured subjects. Spinal Cord. 2001;39:327-335.
,
Functional community ambulation requirements in incomplete spinal cord injured subjects
, Spinal Cord.
, vol. 39
(pg. 327
-335
) van Hedel H, Tomatis L, Muller R. Modulation of leg muscle activity and gait kinematics by walking speed and bodyweight unloading. Gait Posture. 2006;4:35-45.
,
Modulation of leg muscle activity and gait kinematics by walking speed and bodyweight unloading
, Gait Posture.
, vol. 4
(pg. 35
-45
) Wirz M, Zemon D, Rupp R, et al. Effectiveness of automated locomotor training in patients with chronic incomplete spinal cord injury: a multicenter trial. Arch Phys Med Rehabil. 2005;86:672-680.
,
Effectiveness of automated locomotor training in patients with chronic incomplete spinal cord injury: a multicenter trial
, Arch Phys Med Rehabil.
, vol. 86
(pg. 672
-680
) Winchester P, Smith P, Foreman N, et al. A prediction model for determining over ground walking speed after locomotor training in persons with motor incomplete spinal cord injury. J Spinal Cord Med. 2009;32(1):63-71.
,
A prediction model for determining over ground walking speed after locomotor training in persons with motor incomplete spinal cord injury
, J Spinal Cord Med.
, vol. 32
(pg. 63
-71
) Pepin A, Ladouceur M, Barbeau H. Treadmill walking in incomplete spinal-cord-injured subjects: 2. Factors limiting maximal walking speed. Spinal Cord. 2003;41: 271-279.
,
Treadmill walking in incomplete spinal-cord-injured subjects: 2. Factors limiting maximal walking speed
, Spinal Cord.
, vol. 41
(pg. 271
-279
) Tudor-Locke C, Bassett D. How many steps/day are enough? Preliminary pedometer indices for public health. Sports Med. 2004;34(1):1-8.
,
How many steps/day are enough? Preliminary pedometer indices for public health
, Sports Med.
, vol. 34
(pg. 1
-8
) Dobkin B, Barbeau H, Deforge D, et al. The evolution of walking-related outcomes over the first twelve weeks of rehabilitation for incomplete traumatic spinal cord injury: the multicenter randomized spinal cord injury locomotor trial. Neurorehabil Neural Repair. 2007;21(1):25-35.
,
The evolution of walking-related outcomes over the first twelve weeks of rehabilitation for incomplete traumatic spinal cord injury: the multicenter randomized spinal cord injury locomotor trial
, Neurorehabil Neural Repair.
, vol. 21
(pg. 25
-35
) Myers J, Lee M, Kiratli J. Cardiovascular disease in spinal cord injury. Am J Phys Med Rehabil. 2007;86(2):142-152.
,
Cardiovascular disease in spinal cord injury
, Am J Phys Med Rehabil.
, vol. 86
(pg. 142
-152
) Schmid A, Duncan P, Studenski S, et al. Improvements in speed-based gait classifications are meaningful. Stroke. 2007;38:2096-2100.
,
Improvements in speed-based gait classifications are meaningful
, Stroke.
, vol. 38
(pg. 2096
-2100
) Perry J, Garrett M, Gronley J, Mulroy S. Classification of walking handicap in the stroke population. Stroke. 1995;26:982-989.
,
Classification of walking handicap in the stroke population
, Stroke.
, vol. 26
(pg. 982
-989
)
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