INTRODUCTION Individuals with motor-incomplete SCI (m-iSCI) remain limited community ambulators, partly because they have difficulty with the skilled walking requirements of everyday life that require adaptations in inter-joint coordination and range of motion of the lower limbs. Following locomotor training, individuals with SCI show improvements in skilled walking and walking speed, however there is limited understanding of how adaptations in lower limb kinematics following training contribute to improvements in walking. OBJECTIVE To determine the relationship between changes in lower limb kinematics (range of motion and inter-joint coordination) and improvements in walking function (walking speed and skilled walking) following locomotor training. METHODS Lower limb kinematics were recorded from 8 individuals with chronic m-iSCI during treadmill walking before and after a 3-month locomotor training program. Data were also collected from 5 able-bodied individuals to provide normative values. In individuals with SCI, muscle strength was used to define the stronger and weaker limb. Motion analysis was used to determine, hip, knee and ankle angles. Joint angle-angle plots (cyclograms) were used to quantify inter-joint coordination. Shape differences between pre-and post-training cyclograms were used to assess the changes in coordination and their relation to improvements in walking function. Walking function was assessed using the 10MWT for walking speed and the SCI-FAP for skilled walking. Comparing pre- and post-training cyclograms to the able-bodied pattern was used to understand the extent to which changes in coordination involved the recovery of normative motor patterns. RESULTS Following training, improvements in skilled walking were significantly related to changes in hip-ankle coordination (ρ = - .833, p = 0.010) and knee range of motion (ρ = .833, p = 0.010) of the weaker limb. Inter-joint coordination tended to revert towards normative patterns, but not completely. No relationships were observed with walking speed. CONCLUSION Larger changes in hip-ankle coordination and a decrease in knee range of motion in the weaker limb during treadmill walking were related to improvements in skilled walking following locomotor training in individuals with SCI. The changes in coordination seem to reflect some restoration of normative patterns and the adoption of compensatory strategies, depending on the participant.

中文翻译：

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脊髓损伤患者运动适应能力的改善与运动适应有关。

简介运动不全SCI（m-iSCI）的人仍然是社区活动者，这部分是因为他们在日常生活中需要熟练的步行需求方面遇到困难，这些需求需要关节间协调和下肢运动范围的适应。运动训练后，患有SCI的人表现出熟练的步行和步行速度的改善，但是，对训练后下肢运动学的适应性如何有助于步行改善的了解有限。目的确定运动训练后下肢运动学变化（运动范围和关节间协调度）与步行功能改善（步行速度和熟练步行）之间的关系。方法在3个月的运动训练程序之前和之后，在跑步机行走过程中记录了8例患有慢性m-iSCI的个体的下肢运动学。还从5个健全的个体中收集数据以提供规范价值。在患有SCI的个体中，肌肉力量被用来定义肢体的强弱。运动分析被用来确定髋，膝和踝的角度。关节角-角度图（内线图）用于量化关节间的协调性。训练前后的心动图之间的形状差异用于评估协调性的变化及其与步行功能改善的关系。使用10MWT评估步行速度，使用SCI-FAP评估熟练步行，评估步行功能。将训练前和训练后的心电图与健全的模式进行比较，以了解协调变化涉及规范性运动模式恢复的程度。结果训练后，熟练步行的改善与弱肢的髋踝协调性（ρ=-.833，p = 0.010）和膝关节活动范围（ρ= .833，p = 0.010）显着相关。关节间的协调趋向于恢复为规范模式，但并非完全如此。没有观察到与步行速度的关系。结论在跑步机行走过程中，髋-踝协调性的较大变化以及较弱肢体的膝盖运动范围的减少与SCI患者运动训练后熟练行走的改善有关。