불완전 척수손상 후의 자동보행훈련

Auto-Walking Training After Incomplete Spinal Cord Injury

This study was conducted to assess the effects of the gait training method in incomplete spinal cord injured persons using an auto-walking machine. Persons with incomplete spinal cord injury level C or D on the American Spinal Injury Association impairment scale participated for eight weeks in an auto-walking training program. The gait training program was carried out for 15 minutes, three times per day for 8 weeks with an auto-walking machine. The foot rests of the auto-walking machine can be moved forward, downward, backward and upward to make the gait pattern with fixed on crank. The patient's body weight is supported by a harness during waking training. We evaluated the gait speed, physiologic cost index, motor score of lower extremities and the WISCI (walking index for spinal cord injury) level before the training and after the forth and eighth week of walking training. 1. The mean gait speed was significantly increased from .22 m/s at pre-training to .28 m/s after 4 weeks of training and .31 m/s after 8 weeks of training (p=.004). 2. The mean physiologic cost index was decreased from 4.6 beats/min at pre-training to 3.0 beats/min after 4 weeks and 2.0 beats/min after 8 weeks of training, but it was not statistically significant (p=.140). 3. The mean motor score of lower extrernities was significantly increased from 29.8 to 35.8 after 8 weeks of training (p=.043). 4. The mean WISCI level was significantly increased from level 10 to level 19 after 8 weeks of training (p=.007). The results of this study suggest that the gait training program using the auto-walking machine increased the gait speed, muscle strength and galt pattern (WISCI level) in persons with incomplete spinal cord injury. A large, controlled study of this technique is warranted.