Walking speed is associated with walking behavior in ambulatory people with a recent spinal cord injury

Abstract

Regaining and optimizing walking function for mobility and daily physical activity purposes is one of the most important goals during inpatient rehabilitation for many people with incomplete spinal cord injury (iSCI). In clinical practice, walking function is almost exclusively objectified with measures of capacity, such as distance, speed, or ability to perform a task. However, it is unclear to what extent walking capacity relates to actual walking behavior in people with a recent iSCI. Therefore, the aim of this study was to assess the association between walking speed and walking behavior in ambulatory people with a recent iSCI. People with iSCI who were expected to become at least household walkers were tested before discharge from inpatient rehabilitation. Walking capacity was determined by walking speed measured with a standardized 10 meter walking test. Walking behavior was measured objectively, during one week, with a validated accelerometry based activity monitor attached to the front of the thigh. Forty-six people with iSCI participated in this study. Their mean (SD) walking speed was 0.79 (0.41) m/s. The walking time averaged per day varied between 2.1 and 142.6 minutes; the group median (IQR) was 52.7 (15.2–87.8) minutes. A two-tailed spearman's ranked correlation analyses revealed a positive association between walking speed and daily walking time (r s = 0.734, P < 0.000). We found a significant association between walking speed and walking behavior, suggesting that people who walk faster are likely to walk more during daily life.