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Phonpichit C.1, Anukoolkarn K.1, Fusakul Y.2
1Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Physical Therapy, Bangkok, Thailand, 2Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Rehabilitation Medicine, Bangkok, Thailand
Background: Many people suffer from spinal cord injury. All of them aspire to turn to their previous life which is free walk. Unfortunately some of them can walk. Physical therapist plays an important role to improve their quality of life, however, conservative gait training needs good trunk control and powerful upper limbs. Spinal cord injury patients who got damaged upper than thoracic level 4 was affected to trunk muscle activity. They had less expectation to walk again in their life. New innovation has been invented to increase potential for impaired walking person. Robotic gait training device has body weight support system, offering passive stepping and much more walking repetition and prolong training period without physical strain to therapist. This case report suggests a new innovation to improve the quality of life from inability to walk to ambulation with walker.
Purpose: To minimize dependency and determine the advantage of passive gait training in person with incomplete spinal cord injury.
Methods: 71 year-old Thai male who was incomplete spinal cord injury of cervical spine level 6 since October 2015. He can move on bed with partial assistance. He has impaired trunk control. Then, he cannot sit with hands on leg. Physical therapist strengthens his limbs with weight training exercise and improves sitting balance including robotic gait training 2-3 times per weeks for 3 months. AutoAmbulatorTM was used in this study. He wore a hard harness body suit and lifting feet with straps. During walking training, his body weight was supported and both legs were controlled by robotic legs. Passive mode was applied with slow speed for 20 minutes and 30 sessions.
Results: His muscle strength increases all limbs. He can move on bed independently. Both static and dynamic sitting balance is better. Definitely, his ambulatory capability improves from dependent ambulation to walking with walker which functional ambulation classification (FAC) level 1 to level 2.
Conclusion(s): This case report shows continuously neurological recovery including restoration of locomotion after applied passive gait training in the elderly patient. However, more than 1-year spinal cord injury or chronic walking inabilities persons are challenges to treat with passive gait training..
Implications: Walking has many advantages to all persons especially patient. One of rehabilitation goal is ability to walk. However, gait training leads to strain and injure to therapist. Poor trunk control is a limitation on gait training. Robotic gait training device is the best choice to improve quality of life from wheel chair ambulation to return to walk.
Funding acknowledgements: no
Topic: Disability & rehabilitation
Ethics approval: Research Ethics Committee of Vajira Hospital has a policy no requiring ethics approval in a case report.
All authors, affiliations and abstracts have been published as submitted.
