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Objective:  The purpose of this study was to examine the effects of overground locomotor training (OLT) on walking endurance and gastrocnemius oxygen extraction in people with chronic cervical motor-incomplete spinal cord injury (SCI). Design:  Prospective single-arm pre–post pilot study. Setting:  Human Performance Research Laboratory. Participants:  Adult men with traumatic chronic cervical SCI ( n  = 6; age = 30.8 ± 12.5). Intervention:  Twenty-four sessions of structured OLT. Outcome measures:  Walking endurance was determined during a constant work-rate time-to-exhaustion treadmill test. Normalized perceived fatigability was calculated by dividing subjective ratings of tiredness by walking time. Cardiorespiratory outcomes and muscle oxygen extraction were analyzed using breath-by-breath gas-exchange and near-infrared spectroscopy. Results:  OLT resulted in large effects on walking endurance (1232 ± 446 s vs 1645 ± 255 s;  d  = 1.1;  P  = 0.045) and normalized perceived fatigability (5.3 ± 1.5 a.u. vs 3.6 ± 0.9 a.u.;  d  = 1.3;  P  = 0.033). Small-to-medium effects on absolute (2.8 ± 2.5 a.u. vs 4.2 ± 3.5 a.u.;  d  = 0.42;  P  = 0.035) and isotime (2.8 ± 2.5 a.u. vs 3.8 ± 3.0 a.u.;  d  = 0.33;  P  = 0.023) muscle oxygen extraction were also observed after OLT. Conclusion:  These findings provide preliminary data supporting the potential for improved walking endurance, enhanced muscle O 2  extraction, and reduced perceived fatigability in people with chronic cervical motor-incomplete SCI following the OLT program described in this study.

the journal of spinal cord medicine

Walking endurance, muscle oxygen extraction, and perceived fatigability after overground locomotor training in incomplete spinal cord injury: A pilot study