Effects of Aerobic Exercise Training on Fitness and Walking Related Outcomes in Ambulatory Individuals with Chronic Incomplete Spinal Cord Injury

STUDY DESIGN: Single group, pretest-posttest study. OBJECTIVES: To determine the effects of a non-task-specific, voluntary, progressive aerobic exercise training (AET) intervention on fitness and walking-related outcomes in ambulatory adults with chronic motor-incomplete SCI. SETTING: Rehabilitation research center. METHODS: Ten ambulatory individuals (50% female; 57.94 ± 9.33 years old; 11.11 ± 9.66 years post injury) completed voluntary, progressive moderate-to-vigorous intensity AET on a recumbent stepper three days per week for six weeks. The primary outcome measures were aerobic capacity (VO(2peak)) and self-selected overground walking speed (OGWS). Secondary outcome measures included: walking economy, six-minute walk test (6MWT), daily step counts, Walking Index for Spinal Cord Injury (WISCI-II), Dynamic Gait Index (DGI), and Berg Balance Scale (BBS). RESULTS: Nine participants completed all testing and training. Significant improvements in aerobic capacity (P=0.011), OGWS (P=0.023), the percentage of VO(2peak) utilized while walking at self-selected speed (P=0.03), and daily step counts (P=0.025) resulted following training. CONCLUSIONS: The results indicate that total-body, voluntary, progressive AET is safe, feasible, and effective for improving aerobic capacity, walking speed, and select walking-related outcomes in an exclusively ambulatory SCI sample. This study suggests the potential for non-task-specific aerobic exercise to improve walking following incomplete SCI and builds a foundation for further investigation aimed at the development of exercise based rehabilitation strategies to target functionally limiting impairments in ambulatory individuals with chronic SCI.