Walker vs. Wheelchair User: Expected Gains from Lower Extremity Eccentric Resistance Training after Incomplete Spinal Cord Injury

Abstract

Individuals post Incomplete Spinal Cord Injury (iSCI) experience mitigated physical function relative to the degree of injury. Prolonged therapeutic interventions may include strengthening of the affected musculature below the lesion. Eccentric resistance training has shown to positively impact strength and function inferior to the iSCI. It has yet to be determined if the severity of injury impacts sensitivity to such exercise interventions. A 12-week lower extremity, eccentrically-biased resistance training program was implemented in a mixed sample of walkers (n = 4) and wheelchair users (n = 7) with iSCI. Strength, walking speed, mobility, and daily step activity were analyzed using multiple 1 way ANOVAs with percent improvement from pre- to post-test as the dependent variable and community traversing style as the independent-between factors. Traversing style made no impact on strength gained (eccentric and isometric) nor increase in daily step activity (p > 0.05). Chair users experienced greater improvement in walking speed (p = 0.03) and mobility (p = 0.025) when compared to the walkers, respectively. These preliminary data may represent a ceiling effect for community ambulators in respect to walking function without formal gait training. Alternatively, those using chairs may attain walking improvement in the absence of structured walking therapy. Further support is provided for implementation of lower extremity exercise training regardless of severity of iSCI as the trajectory of improvement in strength and step activity was similar between groups.