Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 6 , Pages 762-767, June 2007

The Assessment of Walking Capacity Using the Walking Index for Spinal Cord Injury: Self-Selected Versus Maximal Levels

  • Myeong Ok Kim, MD

      Affiliations

    • Department of Rehabilitation Medicine, Inha University Hospital, Incheon, Korea
    • ,
  • Anthony S. Burns, MD

      Affiliations

    • Department of Rehabilitation Medicine, the Regional SCI Center of the Delaware Valley, Thomas Jefferson University, Philadelphia, PA.
    • Corresponding Author InformationCorrespondence to Anthony S. Burns, MD, Thomas Jefferson University, 132 S 10th St, Ste 375, Main Bldg, Philadelphia, PA 19107
    • ,
  • John F. Ditunno Jr, MD

      Affiliations

    • Department of Rehabilitation Medicine, the Regional SCI Center of the Delaware Valley, Thomas Jefferson University, Philadelphia, PA.
    • ,
  • Ralph J. Marino, MD

      Affiliations

    • Department of Rehabilitation Medicine, the Regional SCI Center of the Delaware Valley, Thomas Jefferson University, Philadelphia, PA.

Abstract 

Kim MO, Burns AS, Ditunno JF Jr, Marino RJ. The assessment of walking capacity using the Walking Index for Spinal Cord Injury: self-selected versus maximal levels.

Objectives

To assess (1) the frequency and magnitude of differences between self-selected and maximal walking capacity following spinal cord injury (SCI) by using the Walking Index for Spinal Cord Injury (WISCI) and (2) how these levels differ in efficiency and velocity.

Design

Prospective cohort.

Setting

Academic medical center.

Participants

Fifty people with chronic incomplete SCI.

Interventions

Not applicable.

Main Outcome Measures

Subjects ambulated at the level used in the community (self-selected WISCI) and the highest level possible (maximal WISCI). Velocity (in m/s), Physiological Cost Index (PCI), and Total Heart Beat Index (THBI) were calculated. Differences were compared using the paired t test (parametric) or Wilcoxon signed-rank test (nonparametric).

Results

For 36 subjects, maximal WISCI was higher than self-selected WISCI; 21 subjects showed an increase of 3 levels or more. Ambulatory velocity was higher for self-selected WISCI compared with maximal WISCI (.68m/s vs .56m/s, P<.001). PCI and THBI at self-selected WISCI were lower than at maximal WISCI (PCI, 0.99 beats/m vs 1.48 beats/m, P<.001; THBI, 3.39 beats/m vs 4.75 beats/m, P<.001).

Conclusions

Many people with chronic SCI are capable of ambulating at multiple levels. For these people, ambulation at self-selected WISCI was more efficient as evidenced by greater velocity and decreased PCI and THBI. The findings have implications for assessing walking capacity within the context of clinical trials.

Key Words: Outcome assessment (health care), Rehabilitation, Spinal cord injuries, Walking

 

 Supported by the National Institute on Disability and Rehabilitation Research, Office of Special Education and Rehabilitative Services, U.S. Department of Education (grant no. H133N000023).No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.Reprints are not available from the author.

PII: S0003-9993(07)00230-4

doi:10.1016/j.apmr.2007.03.021

Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 6 , Pages 762-767, June 2007

Article Tools

* Image Usage & Resolution