Perspectives of individuals with sub-acute spinal cord injury after personalized adapted locomotor training

Abstract

Purpose: Locomotor training after incomplete spinal cord injury can improve walking function, and cardiovascular and muscle health. Participants’ perspectives about locomotor training, however, have not been extensively studied. This study describes the experiences of individuals with sub-acute incomplete spinal cord injury who completed personalized adapted locomotor training; a locomotor-focused rehabilitation tailored to individual goals. Specifically, we examined how participation in this training impacted their lives and what challenges they encountered.

Materials and methods: Following inpatient rehabilitation, seven participants completed 74–197 h of personalized adapted locomotor training. Using conventional content analysis, themes were identified from post-training interviews. Trustworthiness was enhanced through analysis trials, verbatim quotes, and triangulation.

Results: Three themes emerged: motives for participating, perceived benefits, and perceived challenges. Beliefs that higher intensity leads to quicker recovery of prior function motivated participation. Physical and psychological health improvements, favorable training structure, and empowerment to self-manage their rehabilitation were perceived benefits. Neglect of other commitments, acquiring extra services to participate (e.g. accessible transportation), limited transferability to daily walking, and a rigid training structure were perceived challenges. Program recommendations were formed from the perceived challenges.

Conclusions: Personalized adapted locomotor training was positively regarded by participants. Addressing the perceived challenges may improve the training experience.

Implications for Rehabilitation

• Personalized adapted locomotor training (PALT) is a high-intensity locomotor therapy tailored to an individual’s goals.

• The experiences of individuals with iSCI highlight the impact of PALT on physical and psychological well-being.

• PALT has the potential to improve physical functioning and facilitate transitions from inpatient rehabilitation to community living.

• Findings suggest the need for adaptation of PALT to suit the unique needs of each individual.

Keywords:

• Spinal cord injury
• locomotor training
• participant experiences
• qualitative research

Acknowledgements

We thank Jane Davis, Department of Occupational Science and Occupational Therapy at the University of Toronto, for providing valuable comments on an earlier version of this manuscript.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This research was funded by the Ontario Neurotrauma Foundation (2013-SCI-RECOV2–974).