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.
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
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
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 |
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.