Abstract

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 O₂ extraction, and reduced perceived fatigability in people with chronic cervical motor-incomplete SCI following the OLT program described in this study.

摘要

目的：本研究的目的是探讨地上运动训练（OLT）对慢性颈运动不完全性脊髓损伤（SCI）患者步行耐力和腓肠肌吸氧量的影响。

设计：前瞻性单臂前后试点研究。

地点：人类绩效研究实验室。

参与者：患有创伤性慢性颈椎 SCI 的成年男性（n  = 6；年龄 = 30.8 ± 12.5）。

干预：二十四节结构化 OLT。

结果测量：步行耐力是在恒定工作率的跑步机测试中确定的。标准化的感知疲劳度是通过将疲劳的主观评级除以步行时间来计算的。使用逐次呼吸气体交换和近红外光谱分析心肺结果和肌肉氧提取。

结果： OLT 对步行耐力（1232 ± 446 秒 vs 1645 ± 255 秒； d  = 1.1；P  = 0.045）和标准化感知疲劳度（5.3 ± 1.5 au vs 3.6 ± 0.9 au；d  = 1.3；P =  0.045 ）产生很大影响0.033）。对绝对肌氧（2.8 ± 2.5 au vs 4.2 ± 3.5 au； d  = 0.42；P  = 0.035）和等时间（2.8 ± 2.5 au vs 3.8 ± 3.0 au；d  = 0.33；P  = 0.023）肌肉氧有小到中度影响OLT 后也观察到提取情况。

结论：这些研究结果提供了初步数据，支持慢性颈椎运动不完全性 SCI 患者遵循本研究中描述的 OLT 计划可能会改善步行耐力、增强肌肉 O _{2提取并减少感知疲劳。}