Effects of gait-like vibration training on gait intralimb coordination in individuals with incomplete traumatic spinal cord injury

Abstract

Gait training is a key element of intensive functional rehabilitation to improve mobility and participation after an incomplete spinal cord injury (iSCI). Gait-like vibration training is an emerging approach that may improve intralimb coordination as shown by preliminary data gathered in a person with a chronic iSCI. The effects of gait training on intralimb coordination have not been studied extensively. This study aimed to analyse the effects of gait-like vibration training on intralimb coordination in individuals with iSCI. Six participants with iSCI were evaluated pre- ( n = 4/6; missing data for 2 participants) and post–intervention ( n = 6). The intervention consisted of a gait-like vibration program encompassing 15 training sessions during which multiple vibrators reproduced typical sensory activity associated with gait movements in standing ( Fig. 1 ). During pre-intervention evaluation, participants received twelve minutes of vibrations whereas they received 27 minutes of vibrations during the post-intervention evaluation. During these two evaluations, lower limb kinematics during gait was recorded in standing without vibration before and after the vibrations with a three-dimensional motion analysis system. Intralimb coordination, characterized using hip-knee cyclograms, was compared between the beginning and the end of each evaluation conducted pre and post-intervention, respectively, using a qualitative gait classification. Gait cycles variability and cyclograms shape improved mostly at weight acceptance after heel strike ( n = 6) and for knee excursion during swing phase ( n = 5). Knee extension at heel strike was also greater in participants with a crouched gait pattern after one pre-intervention evaluation. One participant changed from the resilient to the regular gait pattern. Gait-like vibration training seems to be beneficial and could improve gait quality through a facilitation of gait movements and a better intralimb coordination. These preliminary results support the potential of gait-like vibration training to improve gait performance after iSCI.