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Thread: Locomotor training for walking after spinal cord injury.

  1. #1

    Locomotor training for walking after spinal cord injury.

    Cochrane Database Syst Rev. 2008 Apr 16;(2):CD006676.

    Locomotor training for walking after spinal cord injury.

    Mehrholz J, Kugler J, Pohl M.

    BACKGROUND: Locomotor training for walking is used in rehabilitation after spinal cord injury (SCI) and might help to improve walking. OBJECTIVES: To assess the effects of locomotor training on improvement in walking for people with traumatic SCI. SEARCH STRATEGY: We searched the Cochrane Injuries Group Specialised Register (last searched June 2007); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 2); MEDLINE (1966 to June 2007); EMBASE (1980 to June 2007); National Research Register (2007, Issue 2); CINAHL (1982 to June 2007); AMED (Allied and Complementary Medicine Database) (1985 to June 2007); SPORTDiscus (1949 to June 2007); PEDro (the Physiotherapy Evidence database) (searched June 2007); COMPENDEX (engineering databases) (1972 to June 2007); INSPEC (1969 to June 2007); and the National Research Register, Zetoc, and Current Controlled Trials research and trials registers. We also handsearched relevant conference proceedings, checked reference lists and contacted study authors in an effort to identify published, unpublished and ongoing trials. SELECTION CRITERIA: We included randomised controlled trials (RCT) that compared locomotor training to any other exercise provided with the goal of improving walking function after SCI or to a no-treatment control group. DATA COLLECTION AND ANALYSIS: Two review authors independently selected trials for inclusion, assessed trial quality and extracted the data. The primary outcomes were the speed of walking and walking capacity at follow up. MAIN RESULTS: Four RCTs involving 222 patients were included in this review. Overall, the results were inconclusive. There was no statistically significant effect of locomotor training on walking function after SCI comparing bodyweight supported treadmill training with or without functional electrical stimulation or robotic-assisted locomotor training. AUTHORS' CONCLUSIONS: There is insufficient evidence from RCTs to conclude that any one locomotor training strategy improves walking function more than another for people with SCI. Research in the form of large RCTs is needed to address specific questions about the type of locomotor training which might be most effective in improving walking function of people with SCI.
    “As the cast of villains in SCI is vast and collaborative, so too must be the chorus of hero's that rise to meet them” Ramer et al 2005

  2. #2
    Senior Member shak's Avatar
    Join Date
    Dec 2007
    british columbia
    I've always been afraid that that would be the result of trying to get us going from the ground up . brain down i'm afraid . anyone got a good idea how to do that?
    "ELE" ~ Jackie Moon

  3. #3
    does this mean...walking does not help recovery for SCIs?
    seems that walking HELPS recovery.

  4. #4
    Quote Originally Posted by freedomdan View Post
    does this mean...walking does not help recovery for SCIs?
    seems that walking HELPS recovery.
    I imagine, if anything, it is good for stretching and muscle memory at the least. Also, I believe this is one of many tools neccesary to help the healing process.

    Recently, for the first time, I used an auto ambulator twice a week for a couple weeks. After a few minutes of using it I felt a lot of pins and needles in my lower extremities. I'm thinking that this has to be nerve stimulation. When I was done I felt great and relaxed and my aches and pains from sitting down for so long were decreased. Spasms were also decreased.

    I'd like to hear anyone elses input on their experiences with locomotor training.

  5. #5
    If you read it carefully, they are not disputing that walking programs help recovery, what they are saying is that one type of walking therapy is not any better than another. I.E. supported treadmill ambulation vs. overground training vs. Lokomat

    Eric Harness, CSCS
    Neuro Ex, Inc
    Adaptive Performance and Neuro Recovery

  6. #6
    Is Project Walk® methodology franchised in Canada?

  7. #7
    We do have a provider that will be opening next year in Saskatchewan

    Eric Harness, CSCS
    Neuro Ex, Inc
    Adaptive Performance and Neuro Recovery

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