Restoration of walking function in an individual with chronic complete (AIS A) spinal cord injury

Kathleen J. Manella, Juana Torres, Edelle C. Field-Fote

Research output: Contribution to journalArticle

32 Scopus citations

Abstract

Objective: The prognosis for further recovery of motor function 2 years after complete spinal cord injury is poor. This case report describes recovery of walking function in an a 33-year-old man two years post T7 spinal cord injury American Spinal Injury Association (ASIA) Impairment Scale (AIS) A following intensive physical therapy and robotic locomotor training. Design: Case report. Methods: The subject engaged in an intensive clinic-based physical therapy program and research-based robotic locomotor training study over a 7-month period. Physical therapy was initiated 4 months prior to entry into the research study, and targeted trunk control, upper extremity strength, and upright mobility. On initial entry into the robotic locomotor training study the subject's AIS A classification was substantiated. Initial, interim, and follow-up tests of sensation, strength, sitting balance, spasticity, and mobility were performed. Results: Lower extremity motor scores improved from 0/50 to 4/50, bilateral hip flexors increased from grade 0/5 to 2/5, warranting injury re-classification from AIS A to C. Intensive physical therapy combined with robotic locomotor training was associated with restoration of short distance walking function with lower extremity braces and a walker. Conclusion: To our knowledge, this is the first report of an individual with chronic spinal cord injury AIS improving in over-ground walking ability following intensive physical therapy and robotic locomotor training. The presence of a neurophysiologically discomplete lesion probably permitted training of operational neural pathways and enabled the development of useful voluntary movement. Journal Compilation

Original languageEnglish (US)
Pages (from-to)795-798
Number of pages4
JournalJournal of Rehabilitation Medicine
Volume42
Issue number8
DOIs
StatePublished - Sep 2010

Keywords

  • Complete spinal cord injury
  • Discomplete spinal cord injury
  • Locomotor training
  • Robotic training

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Medicine(all)

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