Methods for a Randomized trial of weight-supported treadmill training versus conventional training for walking during inpatient rehabilitation after incomplete traumatic spinal cord injury
Methods for a Randomized trial of weight-supported treadmill training versus conventional training for walking during inpatient rehabilitation after incomplete traumatic spinal cord injury
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DOI：
10.1177/0888439003255508
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发表时间：
2003-09-01
影响因子：
4.2
通讯作者：
Scott, M
中科院分区：
文献类型：
--
作者：
Dobkin, BH;Apple, D;Scott, M
作者描述了第一项前瞻性、多中心、随机临床试验（RCT）的基本原理和方法，该试验旨在对急性创伤性脊髓损伤（SCI）早期康复期间的受试者进行任务导向步行干预。实验策略，体重支撑跑步机训练（BWSTT），允许物理治疗师系统地训练患者在跑步机上以增加社区步行的典型速度行走，同时增加负重。治疗师提供语言和触觉提示，以促进行走的运动学、动力学和时间特征。受试者被随机分配到传统的运动治疗方案中，与相同强度和持续时间的BWSTT和地面运动再训练相结合。受试者患有不完全性脊髓损伤（美国脊髓损伤协会分级B、C和D）， C-4至T-10（上运动神经元组）或T-11至L-3（下运动神经元组）。在SCI的8周内，146名受试者被纳入12周的干预。两个单盲主要结局指标是行走的独立性水平，以及那些能够行走的人，行走50英尺的最大速度，在随机化后6个月和12个月进行测试。该研究为将神经科学实验转化为随机对照试验的可行性提供了一个模型，以开发基于证据的康复实践。
The authors describe the rationale and methodology,of the first prospective, multicenter, randomized clinical trial (RCT) of a task-oriented walking intervention for subjects during earl)) rehabilitation for an acute traumatic spinal cord injury (SCI). The experimental strategy, body weight-supported treadmill training (BWSTT), allows physical therapists to systematically train patients to walk on a treadmill at increasing speeds typical of community ambulation with increasing weight bearing. The therapists provide verbal and tactile cues to facilitate the kinematic, kinetic, and temporal features of walking. Subjects were randomly assigned to a conventional therapy program for mobility versus the same intensity and duration of a combination of BWSTT and over ground locomotor retraining. Subjects bad an incomplete SCI (American Spinal Injury Association grades B, C, and D) from C-4 to T-10 (upper motoneuron group) or from T-11 to L-3 (lower motoneuron group). Within 8 weeks of a SCI, 146 subjects were entered for 12 weeks of intervention. The 2 single-blinded primary outcome measures are the level of independence for ambulation and for those who are able to walk, the maximal speed for walking 50 feet, tested 6 and 12 months after randomization. The offers a model for the feasibility of trial's methodology translating neuroscience c experiments into a RCT to develop evidence-based rehabilitation practices.