Phase dependent modulation of soleus H-reflex in healthy, non-injured individuals while walking with an ankle foot orthosis.

Objective: To examine the dynamic modulation of the soleus H-reflex while walking with a posterior leaf spring ankle foot orthosis (PAFO).

Methods: Soleus H-reflexes were evoked on randomly chosen lower limb of fourteen healthy individuals (age range of 22-36 years, 7 women) while walking on a treadmill with and without a PAFO. In order to capture excitability across the duration of the gait cycle, H-reflexes were evoked at heel strike (HS), HS+100ms, HS+200ms, HS+300ms, HS+400ms in the stance phase and at toe-off (TO), TO+100ms, TO+200ms, TO+300ms, TO+400ms in the swing phase respectively.

Minimal detectable change for spatial and temporal measurements of gait after incomplete spinal cord injury.

Background And Purpose: Gait deviations in individuals after incomplete spinal cord injury (ISCI) that are quantified using spatiotemporal (ST) parameters are often targeted during therapeutic interventions. The purpose of our study was to establish reliability and responsiveness of ST parameters of gait after ISCI using an instrumented walkway (GaitMat II).

Methods: Sixteen individuals with ISCI participated in the study.

Soleus H-reflex modulation after motor incomplete spinal cord injury: effects of body position and walking speed.

Objective: To examine position-dependent (semireclined to standing) and walking speed-dependent soleus H-reflex modulation after motor incomplete spinal cord injury (SCI).

Participants: Twenty-six patients with motor incomplete SCI (mean: 45 +/- 15 years) and 16 noninjured people (mean: 38 +/- 14 years).

Methods: Soleus H-reflexes were evoked by tibial nerve stimulation.

Stepping with an ankle foot orthosis re-examined: a mechanical perspective for clinical decision making.

Background: Ankle foot orthoses are used to stabilize the ankle joint and aid toe clearance during stepping in persons after incomplete spinal cord injury. However, little is known about kinematics and kinetics of stepping with an orthosis during the transition from stance-to-swing and swing-to-stance. We intended to examine if an ankle foot orthosis impeded or facilitated optimal ankle, knee and hip joint kinematics, kinetics and spatiotemporal parameters during the transition phases of normal walking.

Ongoing walking recovery 2 years after locomotor training in a child with severe incomplete spinal cord injury.

Background And Purpose: The authors previously reported on walking recovery in a nonambulatory child with chronic, severe, incomplete cervical spinal cord injury (SCI) after 76 sessions of locomotor training (LT). Although clinical measures did not predict his recovery, reciprocal patterned leg movements developed, affording recovery of independent walking with a reverse rolling walker. The long-term functional limitations and secondary complications often associated with pediatric-onset SCI necessitate continued follow-up of children with SCI.

Beyond gait speed: a case report of a multidimensional approach to locomotor rehabilitation outcomes in incomplete spinal cord injury.

Background: The efficacy of locomotor rehabilitation studies has largely been based on clinical measures of gait speed and walking performance. Although critical, gait speed does not fully capture the multidimensional benefits associated with walking recovery. The International Classification of Function, Disability and Health (ICF) model of rehabilitation emphasizes the role of personal and environmental factors in affecting quality of life and personal health status and advocates a broad approach in the assessment and treatment of people with disabling conditions.

Locomotor training restores walking in a nonambulatory child with chronic, severe, incomplete cervical spinal cord injury.

Background And Purpose: Locomotor training (LT) enhances walking in adult experimental animals and humans with mild-to-moderate spinal cord injuries (SCIs). The animal literature suggests that the effects of LT may be greater on an immature nervous system than on a mature nervous system. The purpose of this study was to evaluate the effects of LT in a child with chronic, incomplete SCI.

Neuroplasticity after spinal cord injury and training: an emerging paradigm shift in rehabilitation and walking recovery.

Physical rehabilitation after spinal cord injury has been based on the premise that the nervous system is hard-wired and irreparable. Upon this assumption, clinicians have compensated for irremediable sensorimotor deficits using braces, assistive devices, and wheelchairs to achieve upright and seated mobility. Evidence from basic science, however, demonstrates that the central nervous system after injury is malleable and can learn, and this evidence has challenged our current assumptions.