Keywords: Spinal cord injury, Rehabilitation, Walking function, Outcome measures
 

"Gait Function in spinal cord injury: Assessing and improving gait function after spinal cord injury "
 

The first project aimed to assess the reliability and validity of the 2mWT in individuals with spinal cord injuries SCI. With 50 participants, the results demonstrated strong construct validity and excellent test-retest reliability for the 2mWT, aligning with validation studies in other neurological conditions. The study concludes that the 2mWT offers a suitable and efficient alternative to the 6mWT for evaluating walking function in individuals with SCI, facilitating early incorporation into rehabilitation and enhancing assessment convenience for both clinical and research purposes. 

The second part of this thesis aimed to validate an IMU setup for analysing gait. The setup was initially validated with five healthy individuals, leading to positive results. With the goal of applying this setup to individuals with SCI, a subsequent validation phase included SCI participants. The method, utilizing IMUs alongside conventional optical motion capture (OMC) as a reference, displayed satisfactory performance, aligning with similar sensor-based approaches documented in existing literature. 

The third project aimed to assess the reliability of a sensor setup in individuals with spinal cord injuries (SCI), focusing solely on reliability assessment, with plans to subsequently address responsiveness. Using a group of twenty-six SCI participants, the study analysed gait parameters captured during a 2-minute walk test across two separate days, revealing consistent gait characteristics with good to excellent reliability over a week. The sensor setup not only detected individual gait characteristics but also differentiated patient-specific gait deficits, potentially revolutionizing patient training programs by precisely targeting weaknesses. This approach, utilizing reference data from healthy individuals, offers a nuanced understanding of gait changes during rehabilitation, shedding light on regenerative processes and compensatory mechanisms that drive recovery. 

The fourth project encompassed a randomized clinical pilot study investigating the impact of body weight supported BWS overground training on individuals with SCI regarding their walking function recovery. The data of ten individuals with incomplete SCI were analysed, revealing improved walking performance after the intervention but without significant differences between interventions. Notably, alterations in inter-joint kinematic parameters were more pronounced in the weaker leg. These findings underscore the need for individualized training approaches aligned with rehabilitation goals and current walking capacity, and they provide groundwork for determining optimal strategies for improving walking ability in individuals with SCI through assessments like those conducted in the preceding studies of this thesis. The study outcomes offer a foundation for calculating future randomized clinical trial sample sizes.

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