Building capacity for implementation-the KT Challenge.

Background: The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT Challenge program to assess the impact on uptake, KT capacity, and practice change.

Arm crank ergometer "spin" training improves seated balance and aerobic capacity in people with spinal cord injury.

Background: There is some evidence that upper-body training modalities can improve not only aerobic capacity but also seated balance in people with spinal cord injury (SCI), even in those classified with motor-complete paralysis above T6. Here, we evaluated the effect of arm crank ergometry (ACE) "spin" training on trunk muscle recruitment and its effects on seated balance and aerobic capacity.

Methods: Eight individuals with high-level complete and 6 with either a low-level complete or a motor-incomplete SCI participated in this study.

Acquisition of a precision walking skill and the impact of proprioceptive deficits in people with motor-incomplete spinal cord injury.

Many people with motor-incomplete spinal cord injury (m-iSCI) experience difficulty navigating obstacles, such as curbs and stairs. The ability to relearn walking skills may be limited by proprioceptive deficits. The purpose of this study was to determine the capacity of participants to acquire a precision walking skill, and to evaluate the influence of proprioceptive deficits on the skill acquisition in individuals with m-iSCI.

Overground walking with a robotic exoskeleton elicits trunk muscle activity in people with high-thoracic motor-complete spinal cord injury.

Background: The trunk muscles are critical for postural control. Recent neurophysiological studies have revealed sparing of trunk muscle function in individuals with spinal cord injury (SCI) classified with thoracic or cervical motor-complete injuries. These findings raise the possibility for recruiting and retraining this spared trunk function through rehabilitation.

A systematic review of the effectiveness of task-specific rehabilitation interventions for improving independent sitting and standing function in spinal cord injury.

Context: Impaired balance function after a spinal cord injury (SCI) hinders performance of daily activities.

Objective: To assess the evidence on the effectiveness of task-specific training on sitting and standing function in individuals with SCI across the continuum of care.

Methods: A systematic search was conducted on literature published to June 2016 using people (acute or chronic SCI), task-specific interventions compared to conventional physical therapy, and outcome (sitting or standing balance function).

Overground vs. treadmill-based robotic gait training to improve seated balance in people with motor-complete spinal cord injury: a case report.

Background: Robotic overground gait training devices, such as the Ekso, require users to actively participate in triggering steps through weight-shifting movements. It remains unknown how much the trunk muscles are activated during these movements, and if it is possible to transfer training effects to seated balance control. This study was conducted to compare the activity of postural control muscles of the trunk during overground (Ekso) vs.

The relationship between lower limb proprioceptive sense and locomotor skill acquisition.

Sensorimotor integration is essential for controlling movement and acquiring new motor tasks in humans. The aim of this project was to understand how lower limb proprioceptive sense contributes to the acquisition of a skilled walking task. We assessed lower limb joint position and movement detection sense in healthy human subjects using the Lokomat robotic exoskeleton.

Neuromuscular control of curved walking in people with stroke: Case report.

People are required to adapt their basic walking pattern to turn and change directions safely for activities of daily living. This case study describes the changes in neuromuscular control among individuals with stroke on walking paths of different curvatures. Two men with hemiparetic stroke and one control subject walked along a straight, wide curved, and tight curved pathway while muscle activation of the medial and lateral gastrocnemius was recorded, along with the trajectory of the center of pressure (COP) during the single support phase.

Quantification of Lower Extremity Kinesthesia Deficits Using a Robotic Exoskeleton in People With a Spinal Cord Injury.

Background: Our ability to sense movement is essential for motor control; however, the impact of kinesthesia deficits on functional recovery is not well monitored in the spinal cord injury (SCI) population. One problem is the lack of accurate and reliable tools to measure kinesthesia.

Objective: The purpose of this study was to establish the validity and reliability of a quantitative robotic assessment tool to measure lower limb kinesthesia in people with SCI.

Short-term cortical plasticity associated with feedback-error learning after locomotor training in a patient with incomplete spinal cord injury.

Background And Purpose: For rehabilitation strategies to be effective, training should be based on principles of motor learning, such as feedback-error learning, that facilitate adaptive processes in the nervous system by inducing errors and recalibration of sensory and motor systems. This case report suggests that locomotor resistance training can enhance somatosensory and corticospinal excitability and modulate resting-state brain functional connectivity in a patient with motor-incomplete spinal cord injury (SCI).

Case Description: The short-term cortical plasticity of a 31-year-old man who had sustained an incomplete SCI 9.

Feasibility of sensory tongue stimulation combined with task-specific therapy in people with spinal cord injury: a case study.

Background: Previous evidence suggests the effects of task-specific therapy can be further enhanced when sensory stimulation is combined with motor practice. Sensory tongue stimulation is thought to facilitate activation of regions in the brain that are important for balance and gait. Improvements in balance and gait have significant implications for functional mobility for people with incomplete spinal cord injury (iSCI).

Spatial-temporal gait variability poststroke: variations in measurement and implications for measuring change.

Objective: To determine the responsiveness to change of spatial-temporal gait parameters among stroke survivors for 3 different variability measures: SD, coefficient of variation (CV), and median absolute deviation (MAD).

Design: Retrospective chart review.

Setting: Clinical laboratory in a Canadian hospital.

Correlations between ankle-foot impairments and dropped foot gait deviations among stroke survivors.

Background: The purpose of this paper is to 1) evaluate the relationship between ankle kinematics during gait and standardized measures of ankle impairments among sub-acute stroke survivors, and 2) compare the degree of stroke-related ankle impairment between individuals with and without dropped foot gait deviations.

Methods: Fifty-five independently ambulating stroke survivors participated in this study. Dropped foot was defined as decreased peak dorsiflexion during the swing phase and reduced ankle joint motion in stance.

Ankle-foot orthotic management in neuromuscular disorders: recommendations for future research.

Purpose: To describe research evidence supporting clinical recommendations for ankle-foot orthotic (AFO) prescription and examine common limitations in current research among individuals with stroke and cerebral palsy.

Method: Three databases and one journal website were searched for articles reporting AFO interventions on gait and functional mobility outcome measures in participants with stroke or cerebral palsy. The International Society for Prosthetics and Orthotics (ISPO) best practice recommendations from consensus conferences were reviewed.

Inter-limb centre of pressure symmetry during gait among stroke survivors.

The purpose of the present study was to describe the spatial-temporal parameters of the centre of pressure (COP) trajectory during the single-support phase of gait among stroke survivors and relate these parameters to the severity of sensorimotor impairment. Fifty-seven participants were asked to walk at their preferred and fast speed over a pressure sensitive mat. Outcome measures included anterior-posterior (AP) COP displacement, AP-COP velocity, medial-lateral (ML) COP variability and foot region COP time.