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  • Title: The use of lower limb loading ability as an indicator for independence and safety in ambulatory individuals with spinal cord injury.
    Author: Nithiatthawanon T, Amatachaya P, Thaweewannakij T, Manimmanakorn N, Mato L, Amatachaya S.
    Journal: Eur J Phys Rehabil Med; 2021 Feb; 57(1):85-91. PubMed ID: 32744051.
    Abstract:
    BACKGROUND: Data relating to weight-bearing or lower limb loading ability (LLLA) have been reported wildly in several individuals, mostly with unilateral impairments, but not in ambulatory individuals with spinal cord injury (SCI) who have bilateral sensorimotor deterioration. AIM: To assess the LLLA of ambulatory individuals with SCI who walk independently with and without a walking device, and explore the optimal threshold of the LLLA to determine the independence and safety of these individuals. DESIGN: Cross-sectional study. SETTING: Tertiary rehabilitation centers and communities. POPULATION: Ninety ambulatory participants with SCI. METHODS: Participants were assessed for their LLLA during stepping of the contralateral leg using a digital load cell. In addition, they were assessed using functional mobility tests and interviewed for fall data over the past six months. RESULTS: Participants who walked independently with or without a walking device had an average LLLA of at least 79% of their bodyweight. In addition, the amount of LLLA at least 94-95% of the bodyweight had moderate diagnostic properties to indicate the independence and safety of these individuals (sensitivity =68-77%, specificity =66-81%, and AUC=0.73-0.80). CONCLUSIONS: The clear and objective data relating to LLLA can be used as a critical indicator for the safe and steady mobility, specifically for ambulatory individuals with SCI. These data can be used as an optimal threshold in rehabilitation training, screening and monitoring of their functional alteration over time in clinical, community, and home-based settings. CLINICAL REHABILITATION IMPACT: The LLLA of at least 79% of the bodyweight could determine the ability of independent walking with a walking device, while an LLLA of at least 94-95% of the bodyweight could indicate the ability of walking without a walking device and no multiple falls. These data can be used as an optimal target in rehabilitation training, screening and monitoring of functional alteration over time in various clinical and home-based settings, specifically for ambulatory individuals with SCI.
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