We read with interest the recent article by Riggins and colleagues.
1
The authors highlight a contentious but important issue which needs to be openly
addressed. At issue are the risks of focusing on neural plasticity and walking through
locomotor training and recovery programs in patients with serious spinal cord injury
and very little lower-limb strength. The authors provide some evidence that when walking
is not achieved 1 year later, these patients have high levels of depression and pain,
and a low quality of life. Of course as the authors state, one cannot assume a cause-effect
relationship, because the study is retrospective and does not capture an inception
cohort. However, it does provide preliminary evidence of a possible detrimental effect
of locomotor training and recovery programs for patients with limited or no lower-limb
strength. The authors argue that therapy for these types of patients is currently
focusing on walking and not the training of functional mobility from a seated position.
Consequently, at 1-year postinjury, when walking does not eventuate and patients have
not learned to adequately mobilize in a wheelchair, they are experiencing the detrimental
effects associated with false hope, limited mobility, and restricted community participation.To read this article in full you will need to make a payment
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Reference
- The relationship between quality of life and change in mobility 1 year post injury in individuals with spinal cord injury.Arch Phys Med Rehabil. 2011; 92: 1027-1033
Article info
Footnotes
Disclosure: No commercial party having a direct financial interest in the results of the research supporting this letter has or will confer a benefit on the authors or on any organization with which the authors are associated.
The views expressed in this letter do not necessarily reflect the views of the authors' affiliated institutions.
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Copyright
© 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
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- The Relationship Between Quality of Life and Change in Mobility 1 Year Postinjury in Individuals With Spinal Cord InjuryArchives of Physical Medicine and RehabilitationVol. 92Issue 7
