Wednesday, April 24, 2019

A Note on Locomotor Training

This study on locomotor training (LT) caught my eye because I was able to have a few sessions of this type of training soon after my injury, but was released due to lack of improvement.  LT involves being supported in a harness (often above a treadmill) and having manual assistance at standing and stepping, among other things.  My limited experience with it was before I began walking with a walker and braces all of the time.  (That was not possible at the time I was released from LT, but you can see videos on my YouTube channel.  Hopefully they will encourage others not to give up.)
But back to this study.  Eight centers gave 120 sessions of this training apiece to people with SCIs — and saw positive changes.  As the study concludes, "Delivering at least 120 sessions . . . improves recovery from incomplete chronic SCI."  The hope is that if insurance permits more LT early on, then there will be fewer hospitalizations and complications later. 
Even better is to see what the results actually were.  I came across a write-up published by Kate Willette, wife of one of the participants.  Apparently many of the people in the study did not have "significant improvement" until at least 60 visits, with some seeing nothing until after 80 visits.  She explains that the study involved 69 people with ASIA C or D injuries, meaning that they have some muscle function below the site of injury (the ASIA scale is best left for another post, but can be used as a common shorthand for how much function or ability someone has after a spinal cord injury).  Of those 69 people, 42 could not walk at all at the beginning; at the end, 20 of the 42 were able to manage with rolling or standard walkers, crutches, or canes. 
All of this is pretty amazing.  More than that, although it again shows how slow and tedious recovery can be after an injury like this — and frequently needing external help or equipment — it is not necessarily impossible.  The people who took part in the study had incomplete injuries and were at different stages in their recovery, but many of them did see improvements.  More to come!

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