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.

Walking Devices Used by the Elderly Living in Rural Areas of Thailand

Background: The use of all types of external devices was previously investigated for elderly with and without orthopaedic problems of a developed country. This study describes the proportion, types and the reasons of using a walking device in elderly who live in many rural areas of Thailand. Methods: Participants (n = 390) were interviewed using a questionnaire to ascertain their demographics, health status and types of walking device required for daily activities. Results: Forty-one participants (11%) used a walking device, particularly when walking long distances due to a fear of falling, musculoskeletal pain, and impaired walking ability. The proportion of walking devices used dramatically increased in participants aged 75 years and over (six times of those aged 60–74 years). Most of the participants used a modified walking stick by their own determination (81%), while only 7% used one according to medical prescription. A significant increase in the need of a walking device was seen in participants aged 75 years and over (OR = 13.9; 95% CI 5.9–32.7; P < 0.001), with a medical problem (OR = 45.9; 95% CI 6.7–73.4; P < 0.001) and who required regular medication (OR = 12.7; 95% CI 5.0–33.6; P = 0.001). Conclusion: The findings emphasise the importance of a community health service to promote health status, particularly before 75 years of age.