Abstract
Individuals post Incomplete Spinal Cord Injury (iSCI) experience mitigated physical function relative to the degree of injury. Prolonged therapeutic interventions may include strengthening of the affected musculature below the lesion. Eccentric resistance training has shown to positively impact strength and function inferior to the iSCI. It has yet to be determined if the severity of injury impacts sensitivity to such exercise interventions. A 12-week lower extremity, eccentrically-biased resistance training program was implemented in a mixed sample of walkers (n = 4) and wheelchair users (n = 7) with iSCI. Strength, walking speed, mobility, and daily step activity were analyzed using multiple 1 way ANOVAs with percent improvement from pre- to post-test as the dependent variable and community traversing style as the independent-between factors. Traversing style made no impact on strength gained (eccentric and isometric) nor increase in daily step activity (p > 0.05). Chair users experienced greater improvement in walking speed (p = 0.03) and mobility (p = 0.025) when compared to the walkers, respectively. These preliminary data may represent a ceiling effect for community ambulators in respect to walking function without formal gait training. Alternatively, those using chairs may attain walking improvement in the absence of structured walking therapy. Further support is provided for implementation of lower extremity exercise training regardless of severity of iSCI as the trajectory of improvement in strength and step activity was similar between groups.
Highlights
It was estimated that approximately 280,000 individuals are living with a spinal cord injury in the United States [1]
There were no differences in eccentric strength [F(1,10) = 0.03, p > 0.05], isometric strength [F(1,10) = 0.79, p > 0.05] improvement or daily step activity [F(1,10) = 0.74, p > 0.05] between groups (Figure 1)
Participant 5 and 10 averaged 0 and 4.5 steps per day at baseline, respectively. The purpose of this analysis was to determine the impact of mobility status on improvements observed following Eccentric resistance training (ERT) of the lower extremities for individuals with gait impairments following Incomplete Spinal Cord Injury (iSCI)
Summary
It was estimated that approximately 280,000 individuals are living with a spinal cord injury in the United States [1]. Eccentric muscle action (generation of tension as the muscle lengthens) consumes less oxygen per unit of work, allowing individuals with low cardiovascular ceilings to exercise at higher volumes compared to traditional eccentric + concentric repetitions Those with incomplete spinal cord injury (iSCI) [11][12][13] and other neurological conditions [14][15] have safely performed ERT in adjunct to traditional therapeutic interventions. Outcomes from these studies include improved eccentric and isometric strength, walking function, quality of life, cardiovascular fitness, and muscle volume. This initial investigation compared a sample of individuals completing an ERT program post iSCI who used wheelchairs (WC) as their primary mode of traversing to those who were primarily ambulatory (WALK)
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