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Titre : | Metabolic Responses to 4 Different Body Weight-Supported Locomotor Training Approaches in Persons With Incomplete Spinal Cord Injury (2013) |
Auteurs : | Jochen Kressler ; Mark Nash ; Patricia Burns ; et al. |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (2013/8, 2013) |
Article en page(s) : | pp. 1436-1442 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Exercice physique ; Rééducation et réadaptation |
Mots-clés: | Exercise ; Oxygen consumption ; Consommation d'oxygène |
Résumé : |
Objective To describe metabolic responses accompanying 4 different locomotor training (LT) approaches. Design Single-blind, randomized controlled trial. Setting Rehabilitation research laboratory, academic medical center. Participants Individuals (N=62) with minimal walking function due to chronic motor-incomplete spinal cord injury. Intervention Participants trained 5 days/week for 12 weeks. Groups were treadmill-based LT with manual assistance (TM), transcutaneous electrical stimulation (TS), and a driven gait orthosis (DGO) and overground (OG) LT with electrical stimulation. Main Outcome Measures Oxygen uptake (o2), walking velocity and economy, and substrate utilization during subject-selected slow, moderate, and maximal walking speeds. Results o2 did not increase from pretraining to posttraining for DGO (.00+.18L/min, P=.923). Increases in the other groups depended on walking speed, ranging from .01+.18m/s (P=.860) for TM (slow speed) to .20+.29m/s (P=.017) for TS (maximal speed). All groups increased velocity but to varying degrees (DGO, .01+.18Ln[m/s], P=.829; TM, .07+.29Ln[m/s], P=.371; TS, .33+.45Ln[m/s], P=.013; OG, .52+.61Ln[m/s], P=.007). Changes in walking economy were marginal for DGO and TM (.01+.20Ln[L/m], P=.926, and .00+.42Ln[L/m], P=.981) but significant for TS and OG (.26+.33Ln[L/m], P=.014, and .44+.62Ln[L/m], P=.025). Many participants reached respiratory exchange ratios ≥1 at any speed, rendering it impossible to statistically discern differences in substrate utilization. However, after training, fewer participants reached this ceiling for each speed (slow: 9 vs 6, n=32; moderate: 12 vs 8, n=29; and maximal 15 vs 13, n=28). Conclusions DGO and TM walking training was less effective in increasing o2 and velocity across participant-selected walking speeds, while TS and OG training was more effective in improving these parameters and also walking economy. Therefore, the latter 2 approaches hold greater promise for improving clinically relevant outcomes such as enhanced endurance, functionality, or in-home/community ambulation. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/journal/archives-of-physical-medicine-and-rehabilitation |