Gait analysis on the treadmill - monitoring exercise in the treatment of paraplegia

Study design: A prospective study was performed to evaluate the gait training of seven consecutive spinal cord injured patients and 10 controls on a treadmill using instrumented gait analysis and video documentation. Objectives: To determine whether it is possible to maintain gait motion within physiological limits during treadmill training. Setting: Primary and secondary care unit for spinal cord injury. Heidelberg, Germany. Methods: Treadmill training was instituted as early as possible. Gait analysis was performed when the patients were stable enough to walk without manual aid from therapists and enough endurance to allow measurements. A control group of healthy volunteers were examined as well. Video documentation and a camera system using passive markers were employed. Results: Treadmill training started with weight reduction of 25% of bodyweight (18 (0-35) kg), maximum walking speed 0.28 (0.15-0.7) m/s and maximum walking duration 4.7 (3-7) min. At the end of the training, weight reduction decreased to 9.3 (0-20) kg, maximum walking speed increased to 0.67 (0.23 - 1.1) ms with a maximum walking duration of 11 (8 - 15) min. 3-D motion analysis of hip, knee and ankle demonstrated joint excursions almost entirely within the limits of normal gait. Exceptions were due to fixed contractures. Conclusions: Our data suggests that it is possible to perform early gait training on a treadmill with no supportive orthoses within the physiologic range of joint motion. The risk for repetitive stress injuries or other negative effects is low.