IMPROVING WALKING IN CHRONIC INCOMPLETE SCI
Edelle C. Field-Fote, PhD, PT

One goal in rehabilitation research is to develop strategies to improve motor performance in people with SCI. There is clinical evidence indicating that, due to rewiring of spinal circuitry, improved sensory and motor function can occur following CNS damage. Researchers are striving to understand if novel therapies can influence this rewiring and some, including Dr. Field-Fote, suspect that the spinal cord can be “taught” to walk using rehabilitative interventions.

Recent studies suggest that specific interventions such as body weight support (BWS) and functional electrical stimulation (FES) may influence the spinal circuitry following SCI. BWS assists with the standing phase of walking and FES with the swing phase. By combining BWS and FES, Dr. Field-Fote hypothesized that improvements in walking speed could be achieved both on the treadmill and over-ground in people with chronic incomplete SCI. Volunteers underwent gait training using BWS and FES over a treadmill at a frequency of three days per week for 3 months. All volunteers showed overall improvements in their lower extremity strength and in over-ground walking speed.

This study is the first to report the effects of combining BWS and FES in a SCI population. In the future, when regeneration of injured spinal cord nerves is achieved, it is likely that rehabilitation will be necessary to guide and promote functional circuit development. It is hoped that motor rehabilitation training studies such as those carried out by the Miami Project will provide important baseline data to help researchers assess the effects of future drug treatment and transplantation strategies.