Effects of gait training with weight support feedback walker on walker dependence, lower limb muscle activation, and gait ability in patients with incomplete spinal cord injury: A pilot randomized controlled trial

Abstract

Background Spinal cord injury (SCI) is a devastating condition affecting an individual’s life, particularly through lower extremity paralysis, which limits walking and daily activities. Objectives This study investigated the effects of weight support feedback walker (WSFW) gait training on walker dependence, lower limb muscle activation, and gait ability in patients with incomplete SCI (ISCI). Methods Eleven subjects capable of walking > 20 m with and without a walker were randomly assigned to WSFW gait training (n = 6) or conventional walker (CW) gait training groups (n = 5). All subjects underwent standard physical therapy for 4 weeks. Additionally, the WSFW group participated in WSFW gait training, whereas the CW group participated in CW gait training conducted for 30 min per day, thrice per week, for 4 weeks. Walker dependence (the average force pressing WSFW with the user's arm during walker gait), lower extremity muscle activity (rectus femoris, biceps femoris, and medial gastrocnemius), and gait ability (gait elements: velocity, cadence, step length, and step length asymmetry) were measured to investigate the effects of training. Results The WSFW group showed significant decrease in walker dependence compared to the CW group (P < 0.05). Some lower extremity muscle activation (left side biceps femoris) and velocity of the gait elements were increased in the WSFW group compared with those in the CW group (P < 0.05). Conclusion WSFW gait training could help patients with ISCI transfer their body weight to the paralyzed lower extremity. However, a randomized controlled trial with several subjects is essential to verify the effects of WSFW training.