Journal of Rehabilitation Medicine 51-2 | Page 41

116 A. Piira et al. Table I. Baseline demographics of study subjects according to intervention or control group Variables Sex, n (% males) Age, years, mean (SD) Post-injury time in years, median (range)* Traumatic injury, n (%) Injury level, n (%) Cervical Thoracic Lumbar ASIA classification, n (%) AIS C AIS D Marital status, n (%) Married Other Smoker, n (%) Education, n (%) < 7 years Elementary school High school University At work, yes, n (%) Use of antispasmodics, n (%) BMI (kg/cm 2 ), mean (SD) Ambulation ability, n (%) Wheelchair dependent Wheelchair independent Combined user Use of assistance/day, n (%) None > 2 h 3–5 h > 6 h Intervention Control group group ( n =10) ( n =10) Characteristics Mean (SD) 6 (60) 46 (14) 5 (2–33) 4 (40) 9 (90) 54 (13) 3 (2–22) 6 (60) Number of days a Days from 1 st to last training session 56 (4) 50–60 154 (20) 137–189 3 (30) 4 (40) 3 (30) 5 (50) 4 (40) 1 (10) 3 (30) 7 (70) 3 (30) 7 (70) 3 (30) 7 (70) 1 (10) 4 (40) 6 (60) 1 (10) 1 0 6 3 5 6 0 2 4 4 2 2 (10) (60) (30) (50) (60) 25.7 (5.1) (20) (40) (40) (20) (20) 25.2 (2.5) 5 (50) 3 (30) 2 (20) 2 (20) 2 (20) 6 (60) 6 (60) 3 (30) 0 1 (10) 8 (80) 1 (10) 1 (10) 0 BMI: body mass index; SD: standard deviation; ASIA: American Spinal Injury Association; AIS: American Spinal Injury Association Impairment Scale. Distance stepped per training day, m b Effective stepping time on treadmill, min/day c Used bodyweight support, kg Used stepping speed on treadmill, km/h Used stepping speed on treadmill, m/s 1,202 (420) 36 (12) Min–Max 741–1,746 21–54 24.4 (5.0) 2.0 (0.3) 0.6 (0.1) 9.1–30.6 1.4–2.3 0.4–0.6 a Major public holidays prohibited completing 60 training sessions or participants travel arrangements from the rehabilitation facility to home. b Total of 2 training sessions up to 90 min on treadmill. c Mean kg of all training sessions through stays 1 and 3. SD: standard deviation. Table IV. Mean change in walking distance and walking speed on the treadmill from first to last training session Distance walked per training session, m Speed, km/h Mean diff (95% CI) p-value 301 (–43, 644) 0.9 (0.5, 1.3) 0.08 0.001 95% CI: 95% confidence interval. The difference in mean changes between the groups was 2.7 (95% CI –1.4, 6.8, p = 0.19) (Table V). As part of the statistical plan, a few a priori variables were selected for possible adjustment in the final ana- lyses. Because of the small numbers, the intervention and control groups were imbalanced with respect to baseline levels of some of these a priori selected va- riables. Adjustment by multivariable linear regression did not change the main results (Table SI 1 ). Other outcomes Table II. Outcome measures at baseline Variables Intervention group ( n  =  10) Mean (SD) Control group ( n  =  10) 10MWT, m/s 6MWT, m LEMS BBS, mean (SD) MFR, cm VO 2max , l/min 0.5 (0.5) n  = 8 226 (151) n  = 7 26.9 (13.0) 32 (19) 40 (7) 1.4 (0.5) 0.5 (0.3) n  = 8 165 (98) n  = 7 28.3 (12.6) 29.3 (18.2) 42 (12) 1.5 (0.4) n  = 8 Mean (SD) SD: standard deviation; BMI: body mass index; LEMS: lower extremity motor score; 6MWT: 6-min walk test; 10 MWT: 10-m walk test; WISCI: Walking Index for Spinal Cord Injury; BBS: Berg’s Balance Scale; MFR: Modified Functional Reach test; VO 2max : maximal oxygen uptake. and there was no significant difference bet- ween the groups (–4.3 m (95% CI –52.7, 44.1)) (Table V). One subject was unable to walk due to pain in his lower limb, thus we were only able to repeat the 6MWT in 6 subjects in the control group. Baseline range in LEMS was similar in the 2 groups, 6 to 46 and 8 to 40 points in the intervention and control groups, respectively. In the intervention group, LEMS increased by a mean of 2.1 points (SD 2.8, p = 0.05), whereas there was little change in the control group (mean change –0.6 (SD 5.1), p = 0.75). www.medicaljournals.se/jrm Table III. Body-weight supported locomotor training data from the intervention group, n  = 9 Changes in balance, as measured by BBS and MFR, are shown in Table V. There was no significant difference in change between the groups for either outcome, –1.2 points 95% CI (–4.3, 1.9), p = 0.42 and 6.6 cm (–5.4, 18.5), p = 0.26, respectively, for BBS and MFR (Table V). There was no significant change in VO 2 measure- ment in any group, nor in the difference between them ((0.0 l/min, 95% CI (–0.2, 0.3), p = 0.87)) (Table V). However, for the VO 2 test there were small numbers Table V. Changes in walking speed and walking distance, strength, balance, aerobic capacity, from baseline to evaluation 2–4 weeks post-intervention/ control period Intervention group (n  = 9) Variables 10MWT 6MWT LEMS BBS MFR, cm Mean (SD) 0.2 (0.3) a 25.4 (40.9) a 2.1 (2.8) 0.0 (2.6) 0.8 (15.4) VO 2max l min –1 –0.1 (0.2) a a Difference in mean change between the p-value Mean (SD) p-value groups (95% CI)* p-value 0.14 0.15 0.05 1.00 0.88 0.37 Control group (n  = 9) 0.1 (0.2) a 0.23 29.6 (38.2) b –0.6 (5.1) 1.2 (3.9) –5.8 (6.9) –0.1 (0.2) c 0.1 (–0.2, 0.4) 0.43 0.12 0.75 0.33 0.04 –4.3 (–52.7, 44.1) 2.7 (–1.4, 6.8) –1.2 (–4.3, 1.9) 6.6 (–5.4, 18.5) 0.85 0.19 0.42 0.26 0.18 0.0 (–0.2, 0.3) 0.87 n  = 7, b n  = 6, c n  = 8, *Change in intervention group – change in control group. 10MWT: 10-m walk test; 6MWT: 6-min walk test; LEMS: lower extremity motor score; BBS: Berg’s Balance Scale; MFR: Modified Functional Reach test; VO 2max : maximal oxygen uptake; SD: standard deviation; 95% CI; 95% confidence interval.