Walking Ability Outcome Measures in Individuals with Spinal Cord Injury: A Systematic Review.

Antonio J Del-Ama,Isabel Sinovas-Alonso,Ángel Gil-Agudo,Roberto Cano-De-La-Cuerda

doi:10.3390/ijerph18189517

Abstract

Walking function recovery in spinal cord injury (SCI) is tackled through several therapeutic approaches in which precise evaluation is essential. A systematic review was performed to provide an updated qualitative review of walking ability outcome measures in SCI and to analyze their psychometric properties. PubMed, Cochrane, and PEDro databases were consulted until 1 April 2020. Seventeen articles written in English were included. Five of them studied the walking index for SCI, four studied the 10 meter walk test, and two studied the six-minute walk test, the timed Up and go test, and the Berg balance scale. The rest of the articles studied the following metrics: gait profile score, spinal cord injury functional ambulation profile, five times sit-to-stand test, spinal cord injury functional ambulation inventory, spinal cord independence measure (indoors and outdoors mobility items), locomotor stages in spinal cord injury, community balance and mobility scale, and activity-based balance level evaluation scale. The choice of a single or a set of metrics should be determined by the clinician. Based on the results obtained in this review, a combination of outcome measures is proposed to assess walking ability. Future work is required to integrate a more realistic environment for walking assessment.

Highlights

Published: 9 September 2021Annually, an estimated 250,000–500,000 individuals suffer a spinal cord injury (SCI)worldwide [1]
Twenty-one articles were excluded (Figure 1) because of the following reasons: (i) not directly related to walking ability but to general motor activity or disability; (ii) psychometric properties were not analyzed; (iii) discriminative selection of walking ability outcome measures according to the type of ambulatory assistive devices (AADs)
This paper provides an updated review of the walking ability outcome measures that are currently available to measure ambulation in people with SCI, their psychometric properties, and their limitations

Summary

Introduction

Published: 9 September 2021Annually, an estimated 250,000–500,000 individuals suffer a spinal cord injury (SCI)worldwide [1]. As a result of an SCI, individuals may experience a loss of independence in mobility affecting their community participation and integration, leading to a decreased quality of life [3]. Balance may be compromised after an SCI [4], which affects walking ability [5,6]. Achieving walking ability that is functional, safe, and effective is of high importance in individuals who have an SCI [5], an incomplete SCI (iSCI) [7]. Most patients with iSCIs may recover, to a certain extent, their neurological deficit [8], and approximately 41% of patients with the ability to stand or walk achieve unrestricted ambulatory function six months post-SCI [9]

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