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Neurorehabilitation and Neural Repair, Vol. 17, No. 3,
153-167 (2003)
DOI: 10.1177/0888439003255508
© 2003 American Society of Neurorehabilitation
Methods for a Randomized Trial of Weight-Supported Treadmill Training Versus Conventional Training for Walking During Inpatient Rehabilitation after Incomplete Traumatic Spinal Cord Injury
Bruce H. Dobkin
Department of Neurology, Reed Neurologic Research Center, University of California, Los Angeles, bdobkin{at}mednet.ucla.edu
David Apple
Department of Neurology, Reed Neurologic Research Center, University of California, Los Angeles
Hugues Barbeau
Department of Neurology, Reed Neurologic Research Center, University of California, Los Angeles
Michele Basso
Department of Neurology, Reed Neurologic Research Center, University of California, Los Angeles
Andrea Behrman
Department of Neurology, Reed Neurologic Research Center, University of California, Los Angeles
Dan Deforge
Department of Neurology, Reed Neurologic Research Center, University of California, Los Angeles
John Ditunno
Department of Neurology, Reed Neurologic Research Center, University of California, Los Angeles
Gary Dudley
Department of Neurology, Reed Neurologic Research Center, University of California, Los Angeles
Robert Elashoff
Department of Neurology, Reed Neurologic Research Center, University of California, Los Angeles
Lisa Fugate
Department of Neurology, Reed Neurologic Research Center, University of California, Los Angeles
Susan Harkema
Department of Neurology, Reed Neurologic Research Center, University of California, Los Angeles
Michael Saulino
Department of Neurology, Reed Neurologic Research Center, University of California, Los Angeles
Michael Scott
Department of Neurology, Reed Neurologic Research Center, University of California, Los Angeles
Spinal Cord Injury Locomotor Trial (SCILT) Group
The authors describe the rationale and methodology for the first prospective, multicenter, randomized clinical trial (RCT) of a task-oriented walking intervention for subjects during early rehabilitation for an acute traumatic spinal cord injury (SCI). The experimental strategy, body weight-supported treadmill training (BWSTT), allows physical therapists to systematically train patients to walk on a treadmill at increasing speeds typical of community ambulation with increasing weight bearing. The therapists provide verbal and tactile cues to facilitate the kinematic, kinetic, and temporal features of walking. Subjects were randomly assigned to a conventional therapy program for mobility versus the same intensity and duration of a combination of BWSTT and over-ground locomotor retraining. Subjects had an incomplete SCI (American Spinal Injury Association grades B, C, and D) from C-4 to T-10 (upper motoneuron group) or from T-11 to L-3 (lower motoneuron group). Within 8 weeks of a SCI, 146 subjects were entered for 12 weeks of intervention. The 2 single-blinded primary outcome measures are the level of independence for ambulation and, for those who are able to walk, the maximal speed for walking 50 feet, tested 6 and 12 months after randomization. The trial's methodology offers a model for the feasibility of translating neuroscientific experiments into a RCT to develop evidence-based rehabilitation practices.
Key Words: Motor learning • Locomotor training • Neurologic rehabilitation • Spinal cord
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