Locomotor Training for Spinal Cord Injury

Locomotor training is a type of rehabilitation therapy designed to help individuals with spinal cord injuries (SCIs) recover walking ability and improve mobility. The goal of locomotor training is to retrain the nervous system to control walking patterns, even if the individual has limited or no voluntary control over their legs.

Principles of Locomotor Training

Locomotor training is based on several key principles:

• Task-specific practice: The individual practices walking in a controlled environment, with the goal of relearning normal walking patterns.
• Repetition and intensity: The individual performs repeated walking exercises, with increasing intensity and duration over time.
• Body weight support: The individual's body weight is supported, either partially or fully, to reduce the risk of injury and allow for more intense practice.
• Manual assistance: Trained therapists provide manual assistance to help the individual perform walking movements, if needed.

Types of Locomotor Training

There are several types of locomotor training, including:

• Treadmill-based training: The individual walks on a treadmill, with or without body weight support, while a therapist provides manual assistance.
• Overground walking: The individual practices walking over ground, with or without body weight support, while a therapist provides manual assistance.
• Exoskeleton-based training: The individual wears an exoskeleton, a wearable device that provides mechanical support and assistance, to practice walking.

Benefits of Locomotor Training

Locomotor training has been shown to have several benefits for individuals with SCIs, including:

• Improved walking ability: Many individuals with SCIs are able to recover some or all of their walking ability through locomotor training.
• Increased mobility: Locomotor training can help individuals with SCIs become more mobile and independent.
• Enhanced cardiovascular fitness: Locomotor training can improve cardiovascular fitness and reduce the risk of secondary health complications.
• Improved muscle strength and tone: Locomotor training can help maintain or improve muscle strength and tone in the legs and other affected areas.

Contraindications and Precautions

Locomotor training may not be suitable for all individuals with SCIs, particularly those with:

• Severe osteoporosis: Individuals with severe osteoporosis may be at risk of fractures during locomotor training.
• Unstable spinal injuries: Individuals with unstable spinal injuries may require additional stabilization before participating in locomotor training.
• Other medical conditions: Certain medical conditions, such as cardiovascular disease or respiratory problems, may require special precautions or modifications during locomotor training.

Training and Certification

Locomotor training should only be provided by trained and certified therapists, who have completed specialized education and training in this area. The therapist should work closely with the individual's healthcare team to develop a personalized treatment plan and ensure safe and effective progression of locomotor training.