Beyond gait speed: a case report of a multidimensional approach to locomotor rehabilitation outcomes in incomplete spinal cord injury.
Beyond gait speed: a case report of a multidimensional approach to locomotor rehabilitation outcomes in incomplete spinal cord injury.
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DOI：
10.1097/npt.0b013e3181838291
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发表时间：
2008-09-01
期刊：
影响因子：
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通讯作者：
Behrman, Andrea L
中科院分区：
文献类型：
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作者：
Bowden, Mark G;Hannold, Elizabeth M;Behrman, Andrea L
背景：运动康复研究的有效性主要基于步态速度和步行能力的临床测量。尽管步态速度至关重要，但它并不能完全体现与步行恢复相关的多方面益处。国际功能、残疾和健康分类（ICF）的康复模式强调个人和环境因素在影响生活质量和个人健康状况中的作用，并提倡在残疾人的评估和治疗中采用广泛的方法。OBJECTIVE：本病例报告的目的是描述一种反映ICF模式的多维度结果测量方法。参与者是一个59岁的男子C7美国脊髓损伤协会损伤D四肢瘫痪，16个月后injure.INTERVENTION：参与者完成了45届会议，每周五天的运动训练计划。针对ICF model.OUTCOMES的所有元素，在训练前和训练后完成了综合评估：参与者的步态速度增加可以忽略不计，但增加了自主选择的步行活动，从每天26步到每天1273步。他的辅助设备从平台变成了滚动式步行者，代表脊髓损伤步行指数（WISCI）从8/20增加到13/20。定性访谈表明，态度的转变，导致改善动机，信心，自尊，解决问题，并增加活动/参与社区。最终，参与者能够从养老院安置过渡到living independent.CONCLUSIONS：本病例报告强调，需要超越传统的模式，在损伤和临床水平的评估，以检查干预措施对独立性，社区整合和生活质量的影响。
BACKGROUND: The efficacy of locomotor rehabilitation studies has largely been based on clinical measures of gait speed and walking performance. Although critical, gait speed does not fully capture the multidimensional benefits associated with walking recovery. The International Classification of Function, Disability and Health (ICF) model of rehabilitation emphasizes the role of personal and environmental factors in affecting quality of life and personal health status and advocates a broad approach in the assessment and treatment of people with disabling conditions.OBJECTIVE: The purpose of this case report is to describe a multidimensional approach to outcome measurement reflecting the ICF model.SUBJECT: The participant was a 59-year-old man with C7 American Spinal Injury Association impairment D tetraplegia, 16 months after injury.INTERVENTION: The participant completed a 45-session, five days per week locomotor training program. Comprehensive evaluations were completed pre- and post-training targeting all elements of the ICF model.OUTCOMES: The participant achieved negligible increases in gait speed, but increased self-elected walking activity from 26 steps per day to 1273 steps per day. His assistive device changed from a platform to a rolling walker, representing a Walking Index for Spinal Cord Injury (WISCI) increase from 8/20 to 13/20. Qualitative interviews illustrated an attitudinal shift, leading to improved motivation, confidence, self-esteem, problem-solving, and increased activities/participation in the community. Ultimately, the participant was able to transition from nursing home placement to living independently.CONCLUSIONS: This case report emphasizes the need to move beyond traditional models for evaluation at the impairment and clinical level to examine the effects of interventions on independence, community integration, and quality of life.