Effects of training intensity on locomotor performance in individuals with chronic spinal cord injury: A randomized crossover study

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Study evaluated the effects of locomotor training (LT) intensity on walking outcomes in individuals with motor incomplete spinal cord injury (iSCI). Using randomized a crossover design, 15 ambulatory participants with iSCI for longer than 1 year duration performed either high- or low-intensity LT for up to 20 sessions over 4 to 6 weeks. Four weeks following completion, the training interventions were alternated. Targeted intensities focused on achieving specific ranges of heart rate (HR) or ratings of perceived exertion (RPE), with intensity manipulated by increasing speeds or applying loads. Significantly greater increases in peak treadmill speeds and secondary measures of metabolic function and overground speed were observed following high- versus low-intensity training, with no effects of intervention order. Moderate-to-high correlations were observed between differences in walking speed or distances and differences in HRs or RPEs during high- versus low-intensity training. This pilot study provides the first evidence that the intensity of stepping practice may be an important determinant of LT outcomes in individuals with iSCI. Whether such training is feasible in larger patient populations and contributes to improved locomotor outcomes deserves further consideration.

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