Abstract
Objectives
To primarily explore the proportion and factors relating to failure on an obstacle
crossing task in ambulatory participants with incomplete spinal cord injury (iSCI);
and to compare balance ability between participants who passed and failed on an obstacle
crossing task.
Design
Cross-sectional design.
Setting
Tertiary rehabilitation center.
Participants
Independent ambulatory participants with an iSCI (N=113).
Interventions
Not applicable.
Main Outcome Measures
Primary outcomes were the ability to walk over small obstacles of sizes that are commonly
found in homes and communities and factors relating to failure on an obstacle crossing
task. The secondary outcome was the data from the timed Up and Go (TUG) test.
Results
Of the participants, 33 failed to walk over an obstacle. Using a walker significantly
increased chance of failure, whereas having incomplete paraplegia and American Spinal
Injury Association Impairment Scale grade D were the protective factors for the event
(P≤.01). The number of failures was also significantly increased because of leg contact
with a wide or relative large obstacle (4 and 8cm, P<.001). Furthermore, participants who failed required significantly longer time to
complete the TUG test than those who passed an obstacle crossing task (P<.001).
Conclusions
Apart from the ability of independent walking, rehabilitation professionals may need
to emphasize the ability of movement modification of the lower extremities and balance
control to improve safety issues for the patients.
Keywords
List of abbreviations:
AIS (American Spinal Injury Association Impairment Scale), iSCI (incomplete spinal cord injury), SCI (spinal cord injury), TUG (timed Up and Go)To read this article in full you will need to make a payment
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References
- Muscle force and gait performance: relationships after spinal cord injury.Arch Phys Med Rehabil. 2006; 87: 1218-1722
- Falls in individuals with incomplete spinal cord injury.Spinal Cord. 2007; 45: 37-40
- Factors associated with risk for subsequent injuries after traumatic spinal cord injury.Arch Phys Med Rehabil. 2004; 85: 1503-1508
- Factors related to obstacle crossing in independent ambulatory patients with spinal cord injury.J Spinal Cord Med. 2010; 33: 144-149
- Functional abilities, incidences of complications and falls of patients with spinal cord injury 6 months after discharge.Spinal Cord. 2011; 49: 520-524
- Incidence and factors associated with falls in independent ambulatory individuals with spinal cord injury: a 6-month prospective study.Phys Ther. 2013; 93: 1061-1072
- Effect of stroke on step characteristics of obstacle crossing.Arch Phys Med Rehabil. 2001; 82: 1712-1719
- Motion of the whole body's center of mass when stepping over obstacles of different heights.Gait Posture. 2001; 13: 17-26
- Age and height effects on the center of mass and center of pressure inclination angles during obstacle-crossing.Med Eng Phys. 2008; 30: 968-975
- Symmetrical kinematic changes in highly functioning older patients post-stroke during obstacle-crossing.Gait Posture. 2010; 31: 511-516
- Obstacle crossing in subjects with stroke.Arch Phys Med Rehabil. 1999; 80: 1054-1059
- Outcome measures for gait and ambulation in the spinal cord injury population.J Spinal Cord Med. 2008; 31: 487-499
- Comparing quantification of pain severity by verbal rating and numeric rating scales.J Spinal Cord Med. 2010; 33: 232-242
- Body weight-supported gait training for restoration of walking in people with an incomplete spinal cord injury: a systematic review.J Rehabil Med. 2010; 42: 513-519
- Reference for the 2011 revision of the International Standards for Neurological Classification of Spinal Cord Injury.J Spinal Cord Med. 2011; 34: 547-554
- International Standards for Neurological and Functional Classification of Spinal Cord Injury.Spinal Cord. 1997; 35: 266-274
- Falls in independent ambulatory patients with spinal cord injury: incidence, associated factors and levels of ability.Spinal Cord. 2013; 51: 365-368
- Reliability and validity of three functional tests in ambulatory patients with spinal cord injury.Spinal Cord. 2012; 51: 214-217
- Assistive devices for balance and mobility: benefits, demands, and adverse consequences.Arch Phys Med Rehabil. 2005; 86: 134-145
- Analysis of assisted-gait characteristics in persons with incomplete spinal cord injury.Spinal Cord. 1999; 37: 430-439
- A systematic review of functional ambulation outcome measures in spinal cord injury.Spinal Cord. 2008; 46: 246-254
- The timed ‘Up and Go’ test: a test of basic functional mobility for frail elderly persons.J Am Geriatr Soc. 1991; 39: 142-148
Article info
Publication history
Published online: August 20, 2014
Footnotes
Supported by the Improvement of Physical Performance and Quality of Life Research Group, Faculty of Associated Medical Science; and Khon Kaen University, Khon Kaen, Thailand.
Disclosures: none.
Identification
Copyright
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.