ffectiveness of Automated Locomotor Training in Patients ith Chronic Incomplete Spinal Cord Injury: Multicenter Trial

Objective: To determine whether automated locomotor raining with a driven-gait orthosis (DGO) can increase funcional mobility in people with chronic, motor incomplete spinal ord injury (SCI). Design: Repeated assessment of the same patients or singlease experimental A-B design. Setting: Research units of rehabilitation hospitals in Chicago; eidelberg, Germany; and Basel and Zurich, Switzerland. Participants: Twenty patients with a chronic ( 2y postinury), motor incomplete SCI, classified by the American Spinal njury Association (ASIA) Impairment Scale with ASIA grades (n 9) and D (n 11) injury. Most patients (n 16) were mbulatory before locomotor training. Intervention: Locomotor training was provided using rootic-assisted, body-weight–supported treadmill training 3 to 5 imes a week over 8 weeks. Single training sessions lasted up o 45 minutes of total walking time, with gait speed between 42 and .69m/s and body-weight unloading as low as possible mean standard deviation, 37% 17%). Main Outcome Measures: Primary outcome measures inluded the 10-meter walk test, the 6-minute walk test, the imed Up & Go test, and the Walking Index for Spinal Cord njury–II tests. Secondary measures included lower-extremity otor scores and spastic motor behaviors to assess their poential contribution to changes in locomotor function. All subects were tested before, during, and after training. Results: Locomotor training using the DGO resulted in ignificant improvements in the subjects’ gait velocity, endurnce, and performance of functional tasks. There were no ignificant changes in the requirement of walking aids, rthoses, or external physical assistance. There was no corre-