Evaluation of a training program for persons with SCI paraplegia using the Parastep(R)1 ambulation system .4. Effect on physical self-concept and depression

Objective: To determine whether persons with spinal cord injury (SCI) paraplegia who participated in an electrical stimulation walking program experienced changes in measures of physical self-concept and depression. Design: Before-after trial. Setting: Human SCI applied research laboratory. Participants: Volunteer sample of 12 men and 3 women with SCI paraplegia, mean age 28.75 +/- 6.6yrs and mean duration of injury 3.8 +/- 3.2yrs. Intervention: Thirty-two FNS ambulation training sessions using a commercially available system (Parastep(R)). The hybrid system consists of a microprocessor-controlled stimulator and a modified walking frame with finger-operated switches that permit the user to control the stimulation parameters and activate the stepping. Outcome Measures: The Tennessee Self-Concept Scale (TSCS) and the Beck Depression Inventory (BDI) were administered before and after training. Only the Physical Self subscale of the TSCS was analyzed. After training, individual interviews were performed to assess participants' subjective reactions to the training program. Results: A repeated measures analysis of variance indicated that desired directional and statistically significant changes occurred on the Physical Self subscale of the TSCS (F(1,14) = 8.54, p <.011) and on the BDI (F(1,14) = 5.42, p <.035). Conclusions: Subsequent to the ambulation training program there were statistically significant increases in physical self-concept scores and decreases in depression scores. (C) 1997 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.