NeuroRecovery Network Provides Standardization of Locomotor Training for Persons With Incomplete Spinal Cord Injury

Morrison SA, Forrest GF, VanHiel LR, Dave M, D'Urso D. NeuroRecovery Network provides standardization of locomotor training for persons with incomplete spinal cord injury. Arch Phys Med Rehabil 2012;93:1574-77. Objective: To illustrate the continuity of care afforded by a standardized locomotor training program across a multisite network setting within the Christopher and Dana Reeve Foundation NeuroRecovery Network (NRN). Design: Single patient case study. Setting: Two geographically different hospital-based outpatient facilities. Participants: This case highlights a 25-year-old man diagnosed with C4 motor incomplete spinal cord injury with American Spinal Injury Association Impairment Scale grade D. Intervention: Standardized locomotor training program 5 sessions per week for 1.5 hours per session, for a total of 100 treatment sessions, with 40 sessions at 1 center and 60 at another. Main Outcome Measures: Ten-meter walk test and 6-minute walk test were assessed at admission and discharge across both facilities. For each of the 100 treatment sessions percent body weight support, average, and maximum treadmill speed were evaluated. Results: Locomotor endurance, as measured by the 6-minute walk test, and overground gait speed showed consistent improvement from admission to discharge. Throughout training, the patient decreased the need for body weight support and was able to tolerate faster treadmill speeds. Conclusions: Data indicate that the patient continued to improve on both treatment parameters and walking function. Standardization across the NRN centers provided a mechanism for delivering consistent and reproducible locomotor training programs across 2 facilities without disrupting training or recovery progression.