Evaluation of a training program for persons with SCI paraplegia using the Parastep(R)1 ambulation system .1. Ambulation performance and anthropometric measures

Objective: To describe performance parameters and effects on anthropometric measures in spinal cord injured subjects training with the Parastep(R) 1 system. Design: Before-after trial. Setting: Human spinal cord injury applied research laboratory. Participants: Thirteen men and 3 women with thoracic (T4-T11) motor-complete spinal cord injury: mean age, 28.8yrs; mean duration postinjury, 3.8yrs. Intervention: Thirty-two functional neuromuscular stimulation ambulation training sessions using a commercially available system (Parastep-1). 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: Distance walked, time spent standing and walking, pace, circumferential (shoulders, chest, abdomen, waist, hips, upper arm, thigh, and calf) and skinfold (chest, triceps, axilla, subscapular, supraillium, abdomen, and thigh) measurements, body weight, thigh cross-sectional area, and calculated lean tissue. Results: Statistically significant changes in distance, time standing and walking, and pace were found. Increases in thigh and calf girth, thigh cross-sectional area, and calculated lean tissue, as well as a decrease in thigh skinfold measure, were all statistically significant. Conclusions: The Parastep(R) 1 system enables persons with thoracic-level spinal cord injuries to stand and ambulate short distances but with a high degree of performance variability across individuals. The factors that influence this variability have not been completely identified. (C) 1997 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.