Effects Of Locomotor Training In Subjects With Incomplete SCI – A Randomized Controlled Trial

Research Objectives: To assess the effects of manual body-weight supported locomotor training (BWSLT) in subjects with stable incomplete spinal cord injury (SCI).DesignRandomized single-blinded clinical trial. Setting(s): In-patient rehabilitation with pre-assessment before randomization. Blinded pre-and post-assessments. Participant(s): Subjects (n=34), were minimum two years post injury with grade C or D on the American Spinal Injury Association (ASIA) Impairment Scale were selected. Intervention(s): Intervention (I): BWSLT for 60 days, 1.5 hours per day, 5 days per week over six months. Control (C): usual care.Main Outcome Measure(s)Lower extremity motor score (LEMS), Bergs balance scale (BBS), Ouality of life (SF-36) and pain (VAS). Result(s): In both I and C groups, 73% had some gait function and 6/15 and 7/19, respectively, were ASIA grade C with the rest being grade D. The I-group showed significant improvement in LEMS, mean change 2.27 (CI 0.75, 3.78), p=0.006 compared to no change in the C-group. BBS improved in the I-group [1.79 (CI 0.92, 3.49), p=0.04] with no change in the control group. The I-group reported slightly increased pain during activities 0.73 (CI 0.02, 1.44), p=0.04 compared to that observed in the C-group [-0.26 (-1.03, 0.50)], p=0.48. Subscore Physical Function in QoL improved in both groups, stronger in the I-group [6.92 (CI 0.93, 12.91)], p=0.03. No adverse events were reported except minor issues (superficial wounds) in the lower extremities.Conclusion/DiscussionOverall, manual BWSLT improved lower extremity strength and self-reported physical functioning and maintained balance. Results should be interpreted with caution due to small sample size. Findings will add knowledge about the usefulness of BWSLT in subjects with incomplete SCI.