Study evaluated the effects of task-specific versus impairment-based interventions on walking outcomes in individuals with motor incomplete spinal cord injury (SCI). Using a crossover design, 16 ambulatory participants with incomplete SCI for more than 1 year were randomized to perform either task-specific (upright stepping) or impairment-based training for up to 20 sessions over â?¤6 weeks, with interventions alternated after >4 weeks delay. Both strategies focused on achieving higher cardiovascular intensities, with training specificity manipulated by practicing only stepping practice in variable contexts or practicing tasks targeting impairments underlying locomotor dysfunction (strengthening, balance tasks, and recumbent stepping). Significantly greater increases in fastest overground and treadmill walking speeds were observed following task-specific versus impairment-based training, with moderate associations between differences in amount of practice and outcomes. Gains in balance confidence were also observed following task-specific vs impairment-based training, although incidence of falls was also increased with the former protocol. Limited gains were observed with impairment-based training except for peak power during recumbent stepping tests. The results support findings from other patient populations that the specificity of task practice is a critical determinant of locomotor outcomes and suggest impairment-based exercises may not translate to improvements in functional tasks.
Author(s):
Lotter, Jennifer K. |Henderson, Christopher E. |Plawecki, Abbey |Holthus, Molly E. |Lucas, Emily H. |Ardestani, Marzieh M. |Schmit, Brian D. |Hornby, T. George|
