Abstract
Study design:
An experimental, cross-sectional study.
Objective:
To investigate effects of external information or external cues on gait performance in independent ambulatory incomplete spinal cord injury (iSCI) patients (American Spinal Injury Association C or D, and functional independence measure walking scores=5–7).
Setting:
A university hospital, Thailand.
Method:
Gait performance was assessed in 29 patients with iSCI under four conditions including self-determined fastest walking speed, and fastest walking with the use of visual, auditory and visuotemporal cues. Average gait speed, stride length, cadence and percent step symmetry of these conditions were compared.
Results:
The use of external cues facilitated subjects to walk faster with a greater stride length, cadence and percent step symmetry than their own determination. The visuotemporal cue assisted subjects to increase their walking speed by 0.17 m s−1. The visual cue helped subjects to walk with a significantly greater stride length than the self-determined fastest pace condition (P<0.05). However, the visual cue made subjects walk with the lowest cadence and significantly lower than the visuotemporal cue condition (P<0.05).
Conclusion:
External information helped subjects to reorganize movement characteristics and perform a more efficient spatiotemporal gait pattern. The findings imply a significant role of external information on gait performance in patients with iSCI.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Fouad K, Pearson K . Restoring walking after spinal cord injury. Prog Neurobiol 2004; 73: 107–126.
Van der Salm A, Nene AV, Maxwell DJ, Veltink PH, Hermens HJ, Ijzerman MJ . Gait impairments in a group of patients with incomplete spinal cord injury and their relevance regarding therapeutic approaches using functional electrical stimulation. Artif Organs 2005; 29: 8–14.
Field-Fote E . Spinal cord control of movement: implications for locomotor rehabilitation following spinal cord injury. Phys Ther 2000; 80: 477–484.
Barbeau H, Ladouceur M, Norman KE, Pepin A, Leroux A . Walking after spinal cord injury: evaluation, treatment, and functional recovery. Arch Phys Med Rehabil 1999; 80: 225–235.
Norris JA, Granata KP, Mitros MR, Byrne EM, Marsh AP . Effect of augmented plantarflexion power on preferred walking speed and economy in young and older adults. Gait Posture 2007; 25: 620–627.
Field-Fote E, Tepavac D . Improved intralimb coordination in people with incomplete spinal cord injury following training with body weight support and electrical stimulation. Phys Ther 2002; 82: 707–715.
Perera S, Mody SH, Woodman RC, Studenski SA . Meaningful change and responsiveness in common physical performance measures in older adults. J Am Geriatr Soc 2006; 54: 743–749.
Field-Fote E, Fluet G, Schafer S, Schneider E, Smith R, Downey P et al. The spinal cord injury functional ambulation inventory (SCI-FAI). J Rehabil Med 2001; 33: 177–181.
Azulay JP, Mesure S, Blin O . Influence of visual cues on gait in Parkinson's disease: contribution to attention or sensory dependence? J Neurol Sci 2006; 248: 192–195.
Jiang Y, Normam KE . Effects of visual and auditory cues on gait initiation in people with Parkinson's disease. Clin Rehab 2006; 20: 36–45.
Suteerawattananon M, Morris GS, Etnyre BR, Jankovic J, Protas EJ . Effects of visual and auditory cues on gait in individuals with Parkinson's disease. J Neurol Sci 2004; 219: 63–69.
Van Hedel HJ, Dietz V, Curt A . Assessment of walking speed and distance in subjects with an incomplete spinal cord injury. Neurorehabil Neural Repair 2007; 21: 295–301.
Majsak MJ, Kaminski T, Gentile AM, Flanagan R . The reaching movements of patients with Parkinson's disease under self-determined maximal speed and visually cued conditions. Brain 1998; 121: 755–766.
Beek P, van Wieringen P . Perspectives on the relation between information and dynamics: an epilogue. Hum Mov Sci 1994; 13: 519–533.
Reynolds RF, Day BL . Visual guidance of the human foot during a step. J Physiol 2005; 569: 677–684.
Said C, Goldie P, Patla A, Sparrow W, Martin K . Obstacle crossing in subjects with stroke. Arch Phys Med Rehabil 1999; 80: 1054–1059.
Wagenaar RC, Beek WJ . Hemiplegic gait: a kinematic analysis using walking speed as a basis. J Biomech 1992; 25: 1007–1015.
Wagenaar R, van Emmerik R . Dynamics of pathological gait. Hum Mov Sci 1994; 13: 441–471.
Gibson JJ . The Ecological Approach to Visual Perception. Houghton Mifflin: Boston, 1979.
Bach-y-Rita P, Kercel S . Sensory substitution and the human–machine interface. Trends Cogn Sci 2003; 7: 541–546.
Acknowledgements
This study was supported by grants from the Graduate School and Faculty of Associated Medical Sciences, Khon Kaen University, Thailand.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Amatachaya, S., Keawsutthi, M., Amatachaya, P. et al. Effects of external cues on gait performance in independent ambulatory incomplete spinal cord injury patients. Spinal Cord 47, 668–673 (2009). https://doi.org/10.1038/sc.2008.168
Received:
Revised:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sc.2008.168
Keywords
This article is cited by
-
Immediate effects of lower limb loading exercise during stepping with and without augmented loading feedback on mobility of ambulatory individuals with spinal cord injury: a single-blinded, randomized, cross-over trial
Spinal Cord (2020)
-
Do ambulatory patients with spinal cord injury walk symmetrically?
Spinal Cord (2017)
-
Effects of a visuotemporal cue on walking ability of independent ambulatory subjects with spinal cord injury as compared with healthy subjects
Spinal Cord (2014)
-
Locomotor adaptation to resistance during treadmill training transfers to overground walking in human SCI
Experimental Brain Research (2012)
-
Comparing the efficacy of metronome beeps and stepping stones to adjust gait: steps to follow!
Experimental Brain Research (2011)
