Abstract

Background: Literature supports the achievement of meaningful functional outcomes following long duration intensive locomotor training (LT). However, these long duration protocols may not be feasible in the current reimbursement environment. The purpose of this case report was to determine if similar functional gains can be achieved through a shorter duration, high intensity training in a person with chronic motor-incomplete C4 tetraparesis.

Case presentation: The patient was a 61-year-old male with a chronic incomplete spinal cord injury (iSCI) level C4 ASIA Impairment Scale (AIS) D (16 months). The intervention was initiated after 13 months of traditional outpatient physical therapy.

Discussion: Course of 10 sessions over two weeks of 90-minute intensive locomotor training comprised of body weight supported treadmill training (BWSTT) with manual assistance, overground training, and independent community integration. Improvements in the Berg Balance Scale, Timed Up and Go, independent walking distances, and self-reported quality of life were noted.

Conclusion: A patient with chronic (>1 year) SCI AIS D improved in walking ability and balance after two weeks of intensive locomotor training. The outcomes followed a similar trend seen with long duration protocols.

Keywords: Balance, motor-incomplete spinal cord injury, locomotor training