High-Intensity Variable Stepping Training in Patients With Motor Incomplete Spinal Cord Injury: A Case Series.
Carey L Holleran, Patrick W Hennessey, Abigail L Leddy and 4 others
PMID 29547484WHAT IT FOUND
Four people with incomplete spinal cord injury walked faster and farther after intensive stepping training.
The programme was safe and feasible, but gains vanished within a year. The severe impairments of three participants likely limited how much they could improve.
Key findings
01High-intensity variable stepping training was feasible and safe, with no falls or adverse events, though three of four participants could not consistently maintain the target heart rate.
02Participants showed modest improvements in walking speed and distance, but these gains were not maintained at follow-up more than one year after training.
03Kinematic changes were inconsistent; participants with severe impairments used variable compensatory strategies rather than showing improved coordination.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Only four participants, all with chronic injury and varying levels of impairment, so results cannot be generalized. No control group, so improvements cannot be definitively attributed to the training rather than natural history or testing effects. Three participants had severe motor impairments and could not consistently achieve the target heart rate, which may have limited the dose of training they actually received. Follow-up was at least one year, but the study did not track ongoing exercise habits, so it is unclear why gains were lost.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume this training produces lasting functional recovery. All gains in walking and balance disappeared by the one-year follow-up, suggesting the intervention must be part of a long-term maintenance strategy to have any enduring effect.