Ambulatory assistive devices and walking performance in patients with incomplete spinal cord injury

Study design: A cross-sectional study. Objectives: To primarily explore types of ambulatory assistive device (AAD) used and secondarily describe walking performance in independent ambulatory patients with spinal cord injury (SCI) who walked without and with various AADs as determined using walking speed and distance walked in 6min. Setting: A tertiary rehabilitation center and community hospitals, Thailand. Methods: The data of 195 independent ambulatory patients with SCI were used to describe the use of an AAD. Among these, only 140 subjects were assessed for their walking speed and distance walked in 6min. Results: More than half of the subjects (64%) walked with an AAD in which most of them used a standard walker (45%), followed by a single-tip cane (11%) and bilateral crutches (8%), respectively. The walking speed and distance showed significant differences among the groups (P<0.001), except those who used walker versus crutches, and those who used crutches versus cane (P>0.05). Among the significant variables, types of AAD used had the greatest influence on walking speed and distance of the subjects. Conclusion: More than half of ambulatory subjects with SCI walked with an AAD in which most of them used a standard walker. However, the non-significant differences of walking performance between the groups may suggest the heterogeneity of walking ability in subjects who used the same type of AAD. Therefore, a method to facilitate the use of an AAD with less supportive ability would increase levels of independence for the patients.