Functional community ambulation requirements in incomplete spinal cord injured subjects

Study design: A group of people with incomplete spinal cord injuries (SCI) were evaluated and compared with able-bodied individuals during several wal king conditions. Objectives: To evaluate the functional community ambulation and estimated e nergy expenditure in persons with incomplete SCI and able-bodied individual s. Methods: A list of criteria was used to evaluate functional community ambul ation among participants. Physiological variables, such as the heart rate, oxygen uptake and the lactate concentration, were also measured. Results: Three of nine incomplete SCI subjects and all able-bodied subjects were able to meet all the criteria measured. The required velocity to safe ly cross an intersection was the criterion that the incomplete SCI group ha d the most difficulty reaching. The able-bodied subjects had a comfortable walking velocity twice that of the incomplete SCI subjects' preferred veloc ity. When walking at the same velocity (incomplete SCI subjects' preferred velocity), the incomplete SCI subjects had a rate of oxygen uptake 26% grea ter than the healthy subjects and were 200% less efficient. The lactate con centration also proved to be a useful tool when evaluating the incomplete S CI subjects' walking efficiency. The incomplete SCI subjects lactate concen tration increased after walking at their preferred velocity, meaning that t he anaerobic pathways were used to meet energy demands. Conclusion: Rehabilitation centers should adapt their evaluation forms and increase their criteria requirements to more suitable criteria that are fou nd in the SCI patient's community. The physiological cost should also be ta ken into consideration when evaluating the SCI patient's functional ambulat ion.