Various surfaces challenge gait characteristics of ambulatory patients with spinal cord injury

Abstract

Study DesignA cross-sectional study.ObjectiveTo assess the influence of various surfaces on the gait characteristics of ambulatory participants with incomplete spinal cord injury (SCI) as compared to data from able-bodied participants.SettingA tertiary rehabilitation center and communities.MethodsSeventy participants (35 ambulatory individuals with incomplete SCI and 35 able-bodied individuals with gender- and age-matched) were assessed for their spatiotemporal gait variables while walking over a 10-m walkway of different surfaces (including hard, artificial grass, soft, and pebble surfaces) at a self-selected and fastest speed. The findings were analyzed using the method of manual digitization. The data among the surfaces were compared using Kruskal–Wallis test and Mann–Whitney U test, with a level of statistical significance at P\u2009<\u20090.05.ResultsParticipants with incomplete SCI could safely walk over every surface without any adverse events. Their average stride length, cadence, and walking speed, but not percent step length symmetry, were significantly decreased while walking on the artificial grass, soft, and particularly pebble surfaces as compared to those found on a hard surface. These changes were found particularly in those with SCI, resulting in a walking speed decreased from 0.11 to 0.35\u2009m/s, whereas the reduction of walking speed of able-bodied participants ranged from 0.04 to 0.20\u2009m/s.ConclusionsThe spatiotemporal characteristics of ambulatory participants with SCI were dramatically affected by the surfaces as compared to the data found in able-bodied participants. The findings have potential clinical implications for the incorporation of various surfaces to promote the functional outcomes and safety for ambulatory individuals with SCI.