Increased Lower Limb Loading During Sit-to-Stand is Important for the Potential for Walking Progression in Ambulatory Individuals with Spinal Cord Injury

@#Background: Decreased rehabilitation time may increase the need for walking devices at the time of discharge to promote levels of independence among ambulatory individuals with spinal cord injury (SCI). However, using walking devices could create adverse effects on patients. This study explores the proportion of walking devices used, potential for walking progression, and associated factors among ambulatory individuals with SCI. Methods: Fifty-seven participants were assessed for their demographics and functional ability relating to the requirement for walking devices, including the Timed Up and Go Test (TUGT) and lower limb loading during sit-to-stand (LLL-STS). Results: Thirty-five participants (61%) used a walking device, particularly a standard walker, for daily walking. More than half of them (n = 23, 66%) had potential of walking progression (i.e., safely walk with a less-support device than the usual one). The ability of walking progression was significantly associated with a mild severity of injury, increased lower-limb muscle strength, decreased time to complete the TUGT, and, in particular, increased LLL-STS. Conclusion: A large proportion of ambulatory individuals with SCI have the potential for walking progression, which may increase their level of independence and minimise the appearance of disability. Strategies to promote LLL-STS are important for this progression.

Balance, fall and quality of life in active and inactive elderly

This study aimed to assess the ability of balance control, fall, and quality of life in active and inactive elderly. In active elderly, the study also compared the information in elderly who regularly participated in exercise programs (exercise subjects) and routinely conducted physical activities (lifestyle active subjects). One hundred-and-fifty subjects from several communities in Khon Kaen province, Thailand, aged between 65 to 80 years with a BMI of 20-30 kg/m2 Participated in the study. They were subdivided into 3 groups (50 subjects/group). Each of them was tested on balance ability by using the timed up and go test (TUGT) and berg balance scale (BBS). They were also interviewed regarding their fall history during the past 6 months by using a questionnaire and quality of life by using a self-administered WHOQOL-BREF-THAI questionnaire. There were no significant differences on age, BMI and genders of subjects among the groups. Both exercise and lifestyle active subjects reported a higher rate perceived exertion score (Borg score) of their daily physical or exercise activity than that of inactive subjects (P \< 0.001). Lifestyle active subjects also had the longest duration of their routine physical activities. The results of balance performance showed that exercise subjects achieved the best balance control, followed by lifestyle active and inactive subjects respectively. Inactive subjects required the time to complete TUGT longer than 12 seconds (normative cut-off point for elderly between 65 and 85 years of age). Furthermore, inactive and lifestyle active subjects required the time to complete TUGT longer than exercise subject which was clinically significant from that of the exercise subjects. In addition, the number of inactive subjects who experienced falls during the past 6 months was about 2 times greater than that of active subjects. However, there were no significant differences in quality of life of subjects among the groups (P \> 0.05). Findings of this study confirm that the regular exercise is the best for balance control and fall prevention. However, participation in regular physical activity also benefits for those abilities. Thus the program for balance improvement and fall prevention in elderly should emphasize on regular exercise or physical activity.