Evidence Update: Dynamic Gait Training for Child with SCI
| October 2017
Because good clinical evidence on the benefits of gait training is so scarce, we celebrate every contribution we find. Here’s one that specifically explores the effect of dynamic gait training on a child with a spinal cord injury.
After sustaining a complete T10 spinal cord injury (SCI) at 23 months old, this child began a walking program six months later. She initially started with a posterior walker and HKAFOs, dependent for all stepping and reporting pain and fatigue with the effort.
Dynamic Gait Trainer Improves Activities and Participation
Three months later her therapists introduced a dynamic gait trainer to keep her motivated to walk. They chose a dynamic gait trainer rather than a static one because of the consistent body weight support. The gait trainer allowed her to have her hands free and in addition decreased the pain and fatigue so she could be on her feet for up to an hour and participate in dance class. Over the next years her walking progressed so she no longer needed the trunk support and could walk with reciprocal steps for up to 40 yards in six minutes as well as dancing for an hour. Additionally, although contractures are a frequent sequellae of SCI, this child did not develop any and her family reported that the increased walking made bowel and bladder elimination easier.
She still used the posterior walker in therapy, but the dynamic gait trainer allowed her access to community activities and her dance class.
Interestingly enough, it was not sensorimotor recovery that drove her improvements in independent ambulation (as evidenced by static GMFM scores), but rather providing appropriate adaptive equipment. The researchers determined that the dynamic body weight support and body alignment of gait trainer facilitated better movement with minimal muscle effort with resulting increased access to community and home environments.
Reference (Article is available in full-text)
Altizer W, Noritz G, Paleg G. Use of a dynamic gait trainer for a child with thoracic level spinal cord injury. BMJ Case Rep. 2017.
