Gait training regimen for incomplete spinal cord injury using functional electrical stimulation

Study design: Case series, and repeated assessments of the same individuals. Objective: To demonstrate the feasibility and efficacy of a multiweek intervention on walking function in people with chronic, incomplete spinal cord injuries. Setting: Rehabilitation hospital for spinal cord injury (SCI) in Toronto, Canada. Methods: A convenience sample of five subjects with chronic, incomplete SCI trained for 12 - 18 weeks using a new multichannel neuroprosthesis for walking. The following outcome measures were recorded throughout the training period: walking speed, step frequency and average stride length based on a 2-min walk test. Also identified were which walking aids and orthoses subjects preferred to use, and whether they employed a step-to or step-through gait strategy. Follow-up measurements of three subjects were made up to 10 weeks after treatment. Results: All subjects demonstrated significant improvements in walking function over the training period. Four of the subjects achieved significantly increased walking speeds, which were due to increases in both stride length and step frequency. The fifth subject experienced a significant reduction in preferred assistive devices. Follow-up measurements revealed that two subjects walked slightly slower several weeks after treatment, but they still walked significantly faster than at the start of treatment. Conclusion: The gait training regimen was effective for improving voluntary walking function in a population for whom significant functional changes are not expected. This application of functional electrical therapy is viable for rehabilitation of gait in incomplete SCI.