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Walking in Water and on Land After an Incomplete Spinal Cord Injury

Tamburella, Federica Physical Therapist; Scivoletto, Giorgio MD, PhD; Cosentino, Elena MD; Molinari, Marco MD, PhD

American Journal of Physical Medicine & Rehabilitation: October 2013 - Volume 92 - Issue 10 - p e4–e15
doi: 10.1097/PHM.0b013e3182a1e6c3
Original Research Article

Objective Although no data are available on the effects of water environment on the gait of subjects with spinal cord injury (SCI), hydrotherapy is used in the rehabilitation protocols of SCI patients. The aim of this study was to characterize gait features of subjects with incomplete SCI walking in water and on land in comparison with healthy controls (CTRLs) to identify the specificity of water environment on influencing gait in SCI subjects.

Design This is a matched case-control study.

Results Kinematic gait parameters and range of motion of joint angles of 15 SCI subjects and 15 CTRLs were analyzed. Compared with gait on land, gait in water of the SCI patients was characterized by speed and stance phase reduction, gait cycle time increment, and invariance of stride length and range of motion values. Comparison with CTRL data remarked that walking in water reduces gait differences between the groups. Furthermore, in water, the SCI subjects presented a reduction in variability of the hip and knee joint angles, whereas in the CTRLs, a larger variability was observed.

Conclusions Gait in water of the SCI subjects is associated with kinematic parameters more similar to those of the CTRLs, particularly regarding speed, stride length, and stance phase, supporting the idea that walking in a water environment may be of rehabilitative significance for SCI subjects.

From the Clinical and Research Movement Analysis Laboratory, Spinal Cord Unit, Fondazione Santa Lucia, Rome, Italy.

All correspondence and requests for reprints should be addressed to: Federica Tamburella, Spinal Cord Unit, IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179, Rome, Italy.

Elena Cosentino is now with the IRCCS San Camillo, Venice, Italy.

Presented at the first International Conference of Neurorehabilitation (ICNR), November 14–16, 2012, in Toledo, Spain.

Supported by the Italian Ministry of Health (RC08G) and by the European Commission within the seventh framework Program ICT-2009-247959 MINDWALKER (Mind controlled orthosis and virtual reality training environment for walk empowering).

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2013 by Lippincott Williams & Wilkins