Clinical factors that affect walking level and performance in chronic spinal cord lesion patients

STUDY DESIGN. Observational Study. OBJECTIVE. To evaluate the effects of neurologic and non-neurologic factors on walking level and performance in chronic spinal cord lesion (SCL) patients. SUMMARY OF BACKGROUND DATA. Walking is one of the primary goals of patients after a SCL. Several studies have demonstrated that different neurologic and non-neurologic factors can affect walking level and performance. However, in SCL age and muscle strength have always been considered the major determinants of walking. METHODS. Sixty-five patients with chronic SCL were included. Their demographic, neurologic status (ASIA standards), balance, and spasticity were recorded. Pearson and Spearman correlations were adopted to quantify the association between patients' characteristics and walking ability. The relationship between functional walking measures, Timed Up and Go, Six Minutes Walking Test (SMWT), Ten Meters Walking Test, and Walking Index for Spinal Cord Injury, and demographic and neurologic factors were measured by regression analyses. RESULTS. Strength, balance, spasticity, and age were strictly correlated with walking level and walking performance. They also were the best predictors of walking features. CONCLUSION. Results confirm the recognized importance of age and upper and lower extremity strengths for walking after a SCL. They also highlight the role of 2 other factors, i.e., balance and spasticity, seldom considered as thoroughly in SCL.