Do ambulatory patients with spinal cord injury walk symmetrically?

Study design: Cross-sectional study. Objectives: To explore the levels of walking symmetry in ambulatory participants with spinal cord injury (SCI), and compare levels of walking symmetry among those with different degrees of lesion severity and those who walked with various types of walking devices. Setting: A tertiary rehabilitation center and many communities in Thailand. Methods: Forty-six participants were assessed for their demographics, SCI characteristics and types of walking device used. Then they were recorded for the ability of walking over a 10-m walkway using a digital camera. The levels of walking symmetry were analyzed using a method of manual digitization and reported in terms of percents of step length ratio. Results: Although the participants had bilateral sensorimotor impairments, they showed some degrees of walking asymmetry (similar to 90%), particularly those with American Spinal Injury Association C (AIS C) (85%) and those who walked with a standard walker (78%). Their levels of walking symmetry also significantly differed from those with AIS D (92%; P<0.05) and those who walked without a walking device (95%; P<0.01). Conclusions: Walking symmetry has been reported as an important variable for the ability of well-controlled walking. Therefore, apart from levels of independent walking, rehabilitation professionals need to emphasize improvements in walking symmetry among these individuals.