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Immediate effects of lower limb loading exercise during stepping with and without augmented loading feedback on mobility of ambulatory individuals with spinal cord injury: a single-blinded, randomized, cross-over trial.

Spinal cord
December 1, 2020
Teerawat Nithiatthawanon et al. (6 authors)
Journal ArticleRandomized Controlled TrialHuman StudyClinical
Study Details

Study Goal

The researchers aimed to compare the immediate effects of bodyweight shifting and lower limb loading exercises during stepping with and without augmented feedback, followed by overground walking, on mobility in ambulatory individuals with spinal cord injury.

Results Summary

Both training sessions improved mobility, but the session with augmented feedback showed significantly greater improvements in timed up-and-go, walking speed, sit-to-stand performance, and limb loading compared to training without feedback. The findings suggest augmented feedback enhances rehabilitation outcomes.

Population

Ambulatory individuals with chronic spinal cord injury (post-injury time >6 years).

Effective Dosage

10 minutes per leg of bodyweight shifting and lower limb loading exercises, followed by 10 minutes of overground walking.

Duration

Single intervention session with a 2-week washout period between conditions.

Interactions

None mentioned

Extracted Claims (10)
InterventionDirectionEndpointPopulationDosageImpactClaim #
bodyweight shifting and lower limb loading (LLL) exercise during stepping without augmented loading feedback followed by overground walking
increase
mobility
ambulatory individuals with spinal cord injury (SCI)
-
Significant improvement was found
#1
bodyweight shifting and lower limb loading (LLL) exercise during stepping with augmented loading feedback followed by overground walking
increase
mobility
ambulatory individuals with spinal cord injury (SCI)
-
Significant improvement was found
#2
bodyweight shifting and lower limb loading (LLL) exercise during stepping with augmented loading feedback followed by overground walking
increase
timed up-and-go test (TUG)
ambulatory individuals with spinal cord injury (SCI)
-
improvement was found
#3
bodyweight shifting and lower limb loading (LLL) exercise during stepping with augmented loading feedback followed by overground walking
increase
maximal LLL of the less-affected leg
ambulatory individuals with spinal cord injury (SCI)
-
improvement was found
#4
bodyweight shifting and lower limb loading (LLL) exercise during stepping with augmented loading feedback followed by overground walking
increase
-
ambulatory individuals with spinal cord injury (SCI)
-
improvement was significantly greater than that after training without feedback
#5
bodyweight shifting and lower limb loading (LLL) exercise during stepping with augmented loading feedback followed by overground walking
decrease
timed up-and-go test (TUG)
ambulatory individuals with spinal cord injury (SCI)
1.9 [0.6-3.3]s
between-group differences for the TUG
#6
bodyweight shifting and lower limb loading (LLL) exercise during stepping with augmented loading feedback followed by overground walking
increase
10-m walk test (10MWT)
ambulatory individuals with spinal cord injury (SCI)
0.1 [0.0-0.1]m/s
between-group differences for the 10MWT
#7
bodyweight shifting and lower limb loading (LLL) exercise during stepping with augmented loading feedback followed by overground walking
decrease
five times sit-to-stand test (FTSST)
ambulatory individuals with spinal cord injury (SCI)
1.0 [1.5-4.8]s
between-group differences for the FTSST
#8
bodyweight shifting and lower limb loading (LLL) exercise during stepping with augmented loading feedback followed by overground walking
increase
maximal LLL
ambulatory individuals with spinal cord injury (SCI)
3.1 [1.5-4.8]-2.8 [0.8-4.9]%bodyweight
between-group differences for the LLL
#9
training with augmented loading feedback
increase
mobility
ambulatory individuals with chronic SCI (post-injury time >6 years)
-
immediately enhanced the mobility
#10
Abstract

STUDY DESIGN: Single-blinded, randomized, cross-over design. OBJECTIVES: To compare the immediate effects of bodyweight shifting and lower limb loading (LLL) exercise during stepping with and without augmented loading feedback, followed by overground walking, on the mobility of ambulatory individuals with spinal cord injury (SCI). SETTING: Academic laboratory center. METHODS: Thirty participants with SCI were trained using a single intervention session consisting of repetitive bodyweight shifting and LLL exercises during stepping with or without external feedback (10 min/leg) followed by overground walking (10 min) with a 2-week washout period, in a random sequence. The timed up-and-go test (TUG) (primary outcome), 10-m walk test (10MWT), five times sit-to-stand test (FTSST), and maximal LLL were measured 1 day before and immediately after each training session. RESULTS: Significant improvement was found following both training sessions, excepting the TUG and LLL of the less-affected leg, where improvement was found only after training using augmented feedback. Moreover, the improvement following the training with feedback was significantly greater than that after training without feedback. The mean (95% CI) between-group differences for the TUG = 1.9 [0.6-3.3]s, 10MWT = 0.1 [0.0-0.1]m/s, FTSST = 1.0 [1.5-4.8]s, LLL = 3.1 [1.5-4.8]-2.8 [0.8-4.9]%bodyweight, p < 0.05. CONCLUSIONS: The training programs immediately enhanced the mobility of ambulatory individuals with chronic SCI (post-injury time >6 years), particularly the training with augmented loading feedback. The findings offer another effective rehabilitation strategy that can be applied in various clinical and home-based settings.

Medical Subject Headings (MeSH)
Cross-Over StudiesExercise TherapyFeedbackHumansLower ExtremitySpinal Cord InjuriesWalking
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality80/10
Citation Metrics
Total Citations1
Citations/Year0.2
Relative Citation Ratio0.12
NIH Percentile6%
Research Impact Scores
APT Score0.05
Weight Score1.99
Normalized Score0.70
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