Effects of gait training with weight support feedback walker on walker dependence, lower limb muscle activation, and gait ability in patients with incomplete spinal cord injury: A pilot randomized controlled trial

Background: Spinal cord injury (SCI) is a devastating condition affecting an individual's life, particularly through lower extremity paralysis, which limits walking and daily activities.Objectives: This study investigated the effects of weight support feedback walker (WSFW) gait training on walker dependence, lower limb muscle activation, and gait ability in patients with incomplete SCI (ISCI).Methods: Eleven subjects capable of walking > 20 m with and without a walker were randomly assigned to WSFW gait training (n = 6) or conventional walker (CW) gait training groups (n = 5). All subjects underwent standard physical therapy for 4 weeks. Additionally, the WSFW group participated in WSFW gait training, whereas the CW group participated in CW gait training conducted for 30 min per day, thrice per week, for 4 weeks. Walker dependence (the average force pressing WSFW with the user's arm during walker gait), lower extremity muscle activity (rectus femoris, biceps femoris, and medial gastrocnemius), and gait ability (gait elements: velocity, cadence, step length, and step length asymmetry) were measured to investigate the effects of training.Results: The WSFW group showed significant decrease in walker dependence compared to the CW group (P < 0.05). Some lower extremity muscle activation (left side biceps femoris) and velocity of the gait elements were increased in the WSFW group compared with those in the CW group (P < 0.05).Conclusion: WSFW gait training could help patients with ISCI transfer their body weight to the paralyzed lower extremity. However, a randomized controlled trial with several subjects is essential to verify the effects of WSFW training.