Gait analysis of spinal cord injured subjects: Effects of injury level and spasticity

Objective: To identify abnormalities in the gait of spinal cord injured (SCI) subjects, particularly in relation to injury level and spasticity. Design: Case-control study comparing the gait of SCI individuals with matched controls. Video-motion analysis was used to collect data on temporal and kinematic variables. Spasticity was assessed using the Ashworth score and pendulum test. Data regarding age, height, weight, mechanism, and level of injury were also collected. Setting: Spinal cord injury clinic of a tertiary care hospital. Participants: Twenty-seven SCI individuals volunteered to participate in the study. All had retained walking ability (Frankel D) and could ambulate independently for a minimum of 10 M with or without walking aids. Individuals with cauda equina injuries were excluded from the study. Age, gender, etiology of injury, and interval since injury were not used as exclusion criteria. Ten age-, sex-, and anthropomorphically matched controls were also recruited. Results: Subjects with thoracic injures demonstrated reduced cadence, forward velocity, and knee angular velocity, whereas lumbar injuries resulted in reduced stride length and ankle velocities. These differences were statistically significant (p < .05). Gait in individuals with cervical injuries was not significantly different. Conclusions: Kinematic gait analysis is a sensitive means of quantifying gait abnormalities. Spasticity and injury level determine the pattern of abnormality in gait after spinal cord injury. (C) 1996 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation