practice exam 3 question 89

[Liping Li]

89. Which of the following is not a recommendation for locomotor training after spinal cord injury?
a. Maximize weight-bearing through lower extremities
b. Select walking speeds as close to “normal” as possible
c. Minimize compensatory strategies
d. Minimize level of assistance with use of appropriate bracing

The principles of locomotor training are maximizing load through lower extremities, optimizing sensory cues (including avoiding use of braces and assistive devices), promoting normal kinematics, and avoiding compensations.

May I know why the correct answer is D instead of B? Is it because minimize level of assistance with use of appropriate bracing is not equal to avoid use of braces? But how about a brace that is needed in certain cases? I think it’s B because close to “normal” walking speed may cause compensation while the patient only pursues a fast speed while ignoring the quality of walking.

[Chrissy Durrough Lugge]

Hi Liping,

I am going to revise this question a bit to be more clear. The question specifically pertains to the Behrman and Harkema article and treadmill training. Walking at faster speeds taps into our central pattern generators to facilitate a more normal and reflexive walking pattern.

For functional overground walking, bracing is necessary and effective for many individuals post-SCI. In the right circumstances and with adequate manual assistance, some of these patients may benefit from treadmill training without bracing.

[Author]

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