The utility of upper limb loading device in determining optimal walking ability in ambulatory individuals with spinal cord injury.
Makamas Kumprou, Pipatana Amatachaya, Thanat Sooknuan and 3 others
PMID 34054257WHAT IT FOUND
Most participants could progress to a cane or no device, walking faster and further than walker users.
Upper limb loading correlated with walking ability, suggesting the device may help therapists identify who can safely reduce support.
Key findings
01After assessment, 39% of participants could walk with a single cane, 29% with crutches, 24% with a standard walker, and 8% without any device.
02Participants who could walk with a cane or no device had significantly better walking speed and endurance than those needing a walker or crutches.
03The amount of weight borne by the upper limbs was negatively correlated with lower limb loading ability and walking performance.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was cross-sectional, so it cannot confirm that using the ULLD actually leads to better outcomes or that the device causes progression. Participants were already walking independently, so the results do not apply to those with more severe mobility deficits. The 'optimal walking ability' was determined by a single experienced therapist's opinion, which may introduce subjectivity. There was no clear difference between walker and crutch users in upper limb loading, limiting the device's ability to distinguish between these two groups.
Declared interests
The study was supported by the Thailand Research Fund and the Faculty of Medicine, Khon Kaen University. The authors declared no conflicts of interest.
The easy way to misread this
Do not assume this device is validated for all SCI populations or that it automatically replaces clinical judgment. The study only included those already walking independently, and the 'optimal' status was based on a therapist's opinion, not the device alone.