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Surgical intervention combined with weight-bearing walking training improves neurological recoveries in 320 patients with clinically complete spinal cord injury: a prospective self-controlled study

Although a large number of trials in the SCI field have been conducted, few proven gains have been realized for patients. In the present study, we determined the efficacy of a novel combination treatment involving surgical intervention and long-term weight-bearing walking training in spinal cord inj...

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Autores principales: Liu, Yansheng, Xie, Jia-Xin, Niu, Fang, Xu, Zhexi, Tan, Pengju, Shen, Caihong, Gao, Hongkun, Liu, Song, Ma, Zhengwen, So, Kwok-Fai, Wu, Wutian, Chen, Chen, Gao, Sujuan, Xu, Xiao-Ming, Zhu, Hui
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8178778/
https://www.ncbi.nlm.nih.gov/pubmed/33229715
http://dx.doi.org/10.4103/1673-5374.297080
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author Liu, Yansheng
Xie, Jia-Xin
Niu, Fang
Xu, Zhexi
Tan, Pengju
Shen, Caihong
Gao, Hongkun
Liu, Song
Ma, Zhengwen
So, Kwok-Fai
Wu, Wutian
Chen, Chen
Gao, Sujuan
Xu, Xiao-Ming
Zhu, Hui
author_facet Liu, Yansheng
Xie, Jia-Xin
Niu, Fang
Xu, Zhexi
Tan, Pengju
Shen, Caihong
Gao, Hongkun
Liu, Song
Ma, Zhengwen
So, Kwok-Fai
Wu, Wutian
Chen, Chen
Gao, Sujuan
Xu, Xiao-Ming
Zhu, Hui
author_sort Liu, Yansheng
collection PubMed
description Although a large number of trials in the SCI field have been conducted, few proven gains have been realized for patients. In the present study, we determined the efficacy of a novel combination treatment involving surgical intervention and long-term weight-bearing walking training in spinal cord injury (SCI) subjects clinically diagnosed as complete or American Spinal Injury Association Impairment Scale (AIS) Class A (AIS-A). A total of 320 clinically complete SCI subjects (271 male and 49 female), aged 16–60 years, received early (≤ 7 days, n = 201) or delayed (8–30 days, n = 119) surgical interventions to reduce intraspinal or intramedullary pressure. Fifteen days post-surgery, all subjects received a weight-bearing walking training with the “Kunming Locomotion Training Program (KLTP)” for a duration of 6 months. The neurological deficit and recovery were assessed using the AIS scale and a 10-point Kunming Locomotor Scale (KLS). We found that surgical intervention significantly improved AIS scores measured at 15 days post-surgery as compared to the pre-surgery baseline scores. Significant improvement of AIS scores was detected at 3 and 6 months and the KLS further showed significant improvements between all pair-wise comparisons of time points of 15 days, 3 or 6 months indicating continued improvement in walking scores during the 6-month period. In conclusion, combining surgical intervention within 1 month post-injury and weight-bearing locomotor training promoted continued and statistically significant neurological recoveries in subjects with clinically complete SCI, which generally shows little clinical recovery within the first year after injury and most are permanently disabled. This study was approved by the Science and Research Committee of Kunming General Hospital of PLA and Kunming Tongren Hospital, China and registered at ClinicalTrials.gov (Identifier: NCT04034108) on July 26, 2019.
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spelling pubmed-81787782021-06-22 Surgical intervention combined with weight-bearing walking training improves neurological recoveries in 320 patients with clinically complete spinal cord injury: a prospective self-controlled study Liu, Yansheng Xie, Jia-Xin Niu, Fang Xu, Zhexi Tan, Pengju Shen, Caihong Gao, Hongkun Liu, Song Ma, Zhengwen So, Kwok-Fai Wu, Wutian Chen, Chen Gao, Sujuan Xu, Xiao-Ming Zhu, Hui Neural Regen Res Research Article Although a large number of trials in the SCI field have been conducted, few proven gains have been realized for patients. In the present study, we determined the efficacy of a novel combination treatment involving surgical intervention and long-term weight-bearing walking training in spinal cord injury (SCI) subjects clinically diagnosed as complete or American Spinal Injury Association Impairment Scale (AIS) Class A (AIS-A). A total of 320 clinically complete SCI subjects (271 male and 49 female), aged 16–60 years, received early (≤ 7 days, n = 201) or delayed (8–30 days, n = 119) surgical interventions to reduce intraspinal or intramedullary pressure. Fifteen days post-surgery, all subjects received a weight-bearing walking training with the “Kunming Locomotion Training Program (KLTP)” for a duration of 6 months. The neurological deficit and recovery were assessed using the AIS scale and a 10-point Kunming Locomotor Scale (KLS). We found that surgical intervention significantly improved AIS scores measured at 15 days post-surgery as compared to the pre-surgery baseline scores. Significant improvement of AIS scores was detected at 3 and 6 months and the KLS further showed significant improvements between all pair-wise comparisons of time points of 15 days, 3 or 6 months indicating continued improvement in walking scores during the 6-month period. In conclusion, combining surgical intervention within 1 month post-injury and weight-bearing locomotor training promoted continued and statistically significant neurological recoveries in subjects with clinically complete SCI, which generally shows little clinical recovery within the first year after injury and most are permanently disabled. This study was approved by the Science and Research Committee of Kunming General Hospital of PLA and Kunming Tongren Hospital, China and registered at ClinicalTrials.gov (Identifier: NCT04034108) on July 26, 2019. Wolters Kluwer - Medknow 2020-11-16 /pmc/articles/PMC8178778/ /pubmed/33229715 http://dx.doi.org/10.4103/1673-5374.297080 Text en Copyright: © 2021 Neural Regeneration Research https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Research Article
Liu, Yansheng
Xie, Jia-Xin
Niu, Fang
Xu, Zhexi
Tan, Pengju
Shen, Caihong
Gao, Hongkun
Liu, Song
Ma, Zhengwen
So, Kwok-Fai
Wu, Wutian
Chen, Chen
Gao, Sujuan
Xu, Xiao-Ming
Zhu, Hui
Surgical intervention combined with weight-bearing walking training improves neurological recoveries in 320 patients with clinically complete spinal cord injury: a prospective self-controlled study
title Surgical intervention combined with weight-bearing walking training improves neurological recoveries in 320 patients with clinically complete spinal cord injury: a prospective self-controlled study
title_full Surgical intervention combined with weight-bearing walking training improves neurological recoveries in 320 patients with clinically complete spinal cord injury: a prospective self-controlled study
title_fullStr Surgical intervention combined with weight-bearing walking training improves neurological recoveries in 320 patients with clinically complete spinal cord injury: a prospective self-controlled study
title_full_unstemmed Surgical intervention combined with weight-bearing walking training improves neurological recoveries in 320 patients with clinically complete spinal cord injury: a prospective self-controlled study
title_short Surgical intervention combined with weight-bearing walking training improves neurological recoveries in 320 patients with clinically complete spinal cord injury: a prospective self-controlled study
title_sort surgical intervention combined with weight-bearing walking training improves neurological recoveries in 320 patients with clinically complete spinal cord injury: a prospective self-controlled study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8178778/
https://www.ncbi.nlm.nih.gov/pubmed/33229715
http://dx.doi.org/10.4103/1673-5374.297080
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