Use of water- and land-based gait training to improve walking capacity in adults with complete spinal cord injury: A pilot study

Abstract

Objective: Little is known regarding the extent to which mobility can be improved using gait-based therapies in individuals with complete spinal cord injury (cSCI). Against this backdrop, the purpose of our study was to document changes in walking capacity following an extended period of underwater treadmill training (UTT) and supplemental overground walk training (OWT) in persons with cSCI. Design: Longitudinal design. Setting: University research center. Participants: Five adults (mean age = 41.2 ± 5.9 years) with motor-complete (AIS A), chronic (mean years post-injury = 3.2 ± 1.6 years) cSCI who had not received epidural spinal cord stimulation (eSCS). Intervention: Participants underwent one year of UTT (3 walking bouts per day; 2–3 days per week). Once independent stepping activity in the water was observed, OWT, as tolerated, was performed prior to UTT. Outcome Measure: Walking capacity was evaluated using the Walking Index for Spinal Cord Injury (WISCI-II) prior to UTT (Time 1: T1), six months after the start of UTT (Time 2: T2), and following completion of UTT (Time 3: T3). Results: Non-parametric analyses revealed a significant time effect (P