Table 2.
Studies using BWSTT in chronic SCI (>1 year post-injury)
| Articles | Methods | Results |
|---|---|---|
|
Field-Fote et al. 2005‡‡‡ USA PEDro=6 N= 27 RCT |
27 males & females, age 21–64 yrs, incomplete, C3-T10, >1 year post-injury. Randomized to 4 gait training strategies, 45–50 min, 5X/wk, 12 wks: 1) manual BWSTT (n=7); 2) BWSTT + FES (common peroneal nerve) (n=7); 3) BWS overground+FES (n=7); 4) BWS Lokomat (robotic gait device) (n=6). Outcome measures: walking speed over 6 m (short-bout) and 24.4 m (long-bout) |
No significant differences between pre- and post-intervention walking speed in the manual BWSTT or BWS Lokomat groups. However, there was a tendency for subjects with initially slower walking speeds (< 0.1 m/s) to have a greater percent increase in walking speed (57 to 80%) compared to those with initially faster walking speeds (− 19 to 5%). |
|
Hicks et al. 2005 Canada D&B=18 N=14 pre-post |
14 males & females, age 20–53 yrs, ASIA B (n=2) & C (n=12), C4-L1, 1.2 to 24 yrs post-injury. BWSTT: <45 min, 3X/wk, 144 sessions (12 months). Outcome measures: Walking Capacity Scale (Wernig) |
6/14 subjects improved, but only 3 maintained improvements at 8 months post- training. 3/10 initially non-ambulatory subjects could walk (with assistance) post- training. |
|
Wirz et al. 2005 Switzerland D&B=17 N=20 pre-post |
20 males & females, age 16–64 yrs (mean 40, SD 14), ASIA C (n=9) & D (n=11), C3-L1, 2 to 17 yrs post-injury. BWSTT: <45 min, 3–5X/wk, 8 wks. Outcome measures: WISCI II, 10MWT, 6MWT |
2/20 subjects improved WISCI II scores. Overall ↑ in 10MWT of 0.11 +/− 0.10 m/s (56% improvement). 15/16 subjects improved in 6MWT. |
|
Winchester et al 2005 USA D&B=14 N=2 pre-post |
2 males, age 44–49 yrs, ASIA C, C5-C6, 1–4 yrs post- injury. BWSTT: 60 min, 3X/wk, 12 wks. Progressed to minimum of 20 min BWSTT + overground gait training. Outcome measures: WISCI II, gait speed (over 3.66 m walkway), LEMS |
Both subjects initially non-ambulatory. 1 subject improved (WISCI-II =6, gait speed=10.5 cm/s, ↑ LEMS 22→27), other showed no change. |
|
Protas et al 2001 USA D&B=13 N=3 pre-post |
3 males, age 34–48 yrs, ASIA C & D, T8-T12, 2–13 yrs post-injury. BWSTT: 20 min, 5X/wk, 12 wks. Outcome measures: Garrett Scale of Walking, Assistive Device Usage Scale, Orthotic Device Usage Scale, gait speed (5 m), gait endurance (5 minutes). |
All subjects showed ↑ gait speed and endurance. All subjects showed improvement, indicated by the Garrett Scale of Walking or the type of assistive or orthotic devices used. |
|
Wernig et al. 1998 Germany D&B=12 N=35 pre-post |
35 males & females, age 19–70, C4-T12, 1 to 15 yrs post- injury. BWSTT: 30–60 min, 5X/wk, 8–20 wks. Outcome measures: Walking Capacity Scale (Wernig). |
20/25 initially non-ambulatory improved to walking with aids. 2/10 ambulatory patients improved functional class, but all improved speed and endurance. At follow-up (0.5–6.5 yrs later) all ambulatory patients remained ambulatory, with changes only in functional class. |
|
Thomas & Gorassini 2005 Canada D&B=12 N=6 pre-post |
6 males & females, age 29–78 (mean 54.4, SD 14.8) yrs, ASIA C (n=4) & D (n=2), C5-L1, 2 to 28 yrs post-injury. BWSTT: <60 min, 3–5X/wk, 10–23 wks. Outcome measures: 10MWT, 6MWT, WISCI II. |
5/6 subjects improved WISCI II score. Overall significant improvements in 6MWT, and 10MWT and improvements correlated with the increase in corticospinal connectivity. |
|
Hornby et al. 2005 USA D&B=12 N=1 case report |
1 male, age 43 yrs, ASIA C, C6, 18 months post-injury. BWSTT: 1–3X/wk, 16 wks + 3 sessions of PT and OT/wk, which included gait and mobility training. Outcome measures: LEMS, FIM, WISCI II, 10MWT, 6MWT, TUG, Functional Reach Test (postural stability in sit or stand) |
No change in LEMS (remained at 31/50). ↑gait speed (0.11 → 0.21 m/s) and endurance (30 → 61 m) No change in WISCI II (13). |
|
Effing et al 2006 Netherlands D&B=11 N=3 pre-post |
3 males, age 45–51 yrs, ASIA C & D, C5-C7, 29–198 months post-injury. BWSTT: 30 minutes, 5X/wk, 12 wks. Outcome measures: Walking Capability Scale (Wernig), gait speed over 7 m |
Gait improvements in all subjects, indicated either by faster gait speed or higher score in Walking Capability Scale. |
|
Behrman et al 2005 USA D&B=11 N=1 case report |
1 male, age 55 yrs, ASIA D, C5/6 BWSTT for 30 min + overground gait training for 20 min, 5X/wk, 9 wks. Outcome measures: gait speed, WISCI II, # of steps/day |
↑ self-selected gait speed: 0.19 → 1.01 m/s ↑ maximum gait speed: 0.36 → 1.2 m/s ↑ WISCI II: 6 → 20 ↑ steps/day: 1054 → 3924 steps/day |
|
Wernig et al. 1995 Germany D&B=9 N=68 case control |
Study 1: 44 males & females, chronic para- or tetraplegia. BWSTT: 30–60 min, 5X/wk, 3–20 wks (median 10.5 wks). Study 2: 53 males & females, chronic para- or tetraplegia. 29 subjects underwent BWSTT (as in Study 1) versus 24 historical controls who underwent conventional rehabilitation. Outcome measures: Wernig Walking Capacity Scale |
Study 1: 25/33 initially non-ambulatory could walk after BWSTT. At 6 months post- training, 18/21 ambulatory patients maintained abilities. Study 2: 14/18 initially non-ambulatory subjects could walk after BWSTT, compared with only 1/14 in the conventional rehab group. |
***
10-Metre Walk Test
†††
Timed Up and Go test
‡‡‡
Only the results from subjects who were in the manual- or Lokomat-assisted BWSTT groups are included in this table.