A walk to a better tomorrow : improving functional mobility in adults with incomplete spinal cord injury /

Abstract

The objective of this dissertation was to increase the body of knowledge related to functional mobility and physical activity in adults with incomplete spinal cord injury (SCI). By identifying key determinants which underlie the recovery of walking in persons with SCI, a foundation can be laid to develop and implement activity-based interventions which can enhance community ambulation and physical health in this physically-challenged population. To explore this topic, two studies were performed. The primary aim of Study 1 was to explore interrelationships among lower-extremity strength, preferred walking speed, and daily step activity in 21 adults (17 males, 4 females; age = 39 +/- 12 years; 3 +/- 2 years post-injury) with incomplete SCI and to quantify the proportion of explained variance in daily step activity accounted for by leg strength and preferred walking speed. Analysis of data collected in Study 1 revealed the presence of statistically significant associations of moderate to strong magnitude (r = .74--.87) among lower-limb strength, normal walking speed, and daily step counts. In addition, lower-extremity strength and preferred walking speed accounted for 83% of the variance in daily step activity. Results obtained from Study 1 provided the basis for conducting Study 2, which documented the effects of an 8-week underwater treadmill training (UTT) program on lower-extremity strength, balance, and five indices of functional walking performance in 11 adults (7 males, 4 females, age = 48 +/- 14 years; 5 +/- 8 years post-injury) with incomplete SCI. Findings from this second investigation revealed that UTT produced significant improvements of moderate to strong magnitude in leg strength, balance, preferred and rapid walking speeds, 6-minute walk distance, and daily step activity. Viewed collectively, results from both Studies 1 and 2 provide support for contemporary theories which suggest that the adult central nervous system has the capacity to repair and reor