Effects of four-week lower limb loading training with and without augmented feedback on mobility, walking device use, and falls among ambulatory individuals with spinal cord injury: a randomized controlled trial

Abstract

Purpose: To compare the effects of lower limb loading training (LLLT) with or without augmented loading feedback during stepping activity on mobility, walking device use, and falls among ambulatory individuals with chronic spinal cord injury (SCI).

Study design: Randomized controlled trial (assessor-blinded) with prospective fall data follow-up, clinical trial registration (NCT03254797).

Methods: Forty-four ambulatory participants (22 participants/group) were prospectively monitored for their baseline fall data over six months, with baseline assessments for their mobility and walking device used after six months. Then participants involved in the LLLT programs with or without loading feedback according to their groups for 30 min/day, 5 days/week, over 4 weeks. Mobility outcomes were re-assessed at week two and week four, with prospective fall data monitoring over six months, and mobility measured thereafter.

Results: Mobility outcomes of the participants were significantly improved from their baseline ability, especially in those who were trained using augmented feedback (the difference in main outcome, timed up and go, between the groups was 1.8 s; 95% confidence interval = 1.0-3.5s).

Conclusions: LLLT during stepping activity, especially with augmented loading feedback, could be applied effectively to promote mobility and safety of ambulatory individuals with chronic SCI (post-injury time of approximately four years).

Keywords: Balance; fall; movement; rehabilitation; walking; weight-bearing.