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J Rehabil Med. 2010 Sep;42(8):795-8. doi: 10.2340/16501977-0593.

Restoration of walking function in an individual with chronic complete (AIS A) spinal cord injury.

Author information

1
Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, Florida, USA.

Abstract

OBJECTIVE:

The prognosis for further recovery of motor function 2 years after complete spinal cord injury is poor. This case report describes recovery of walking function in an a 33-year old man two years post T7 spinal cord injury American Spinal Injury Association Impairment Scale A following intensive physical therapy and robotic locomotor training.

DESIGN:

Case report.

METHODS:

The subject engaged in an intensive clinic-based physical therapy program and research-based robotic locomotor training study over a 7-month period. Physical therapy was initiated 4 months prior to entry into the research study, and targeted trunk control, upper extremity strength, and upright mobility. On initial entry into the robotic locomotor training study the subject's AIS A classification was substantiated. Initial, interim, and follow-up tests of sensation, strength, sitting balance, spasticity, and mobility were performed.

RESULTS:

Lower extremity motor scores improved from 0/50 to 4/50, bilateral hip flexors increased from grade 0/5 to 2/5, warranting injury re-classification from American Spinal Injury Association Impairment Scale A to C. Intensive physical therapy combined with robotic locomotor training was associated with restoration of short distance walking function with lower extremity braces and a walker.

CONCLUSION:

To our knowledge, this is the first report of an individual with chronic spinal cord injury American Spinal Injury Association Impairment Scale A improving in over-ground walking ability following intensive physical therapy and robotic locomotor training. The presence of a neurophysiologically discomplete lesion probably permitted training of operational neural pathways and enabled the development of useful voluntary movement.

PMID:
20809063
DOI:
10.2340/16501977-0593
[Indexed for MEDLINE]
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