Training of Eccentric Hip Function After SCI

Lower extremity eccentric motor control is is critically important for locomotor function but
is impaired after spinal cord injury (SCI). Even after treadmill training, preliminary
evidence indicates that eccentric deficits persist among individuals with SCI. This proposal
aims to characterize eccentric motor control of the muscles about the hip during locomotion
and evaluate the efficacy of downhill gait training at slow speeds as an intervention to
improve eccentric function of the hip joint during walking.

Individuals with SCI:

Inclusion Criteria:

- medically approved

- discharged from outpatient rehabilitation for 6 months

- incomplete SCI based on ASIA impairment score (AIS C or D) at neurologic level C1-T10

- ability to take some steps overground and on the treadmill

- 18-90 years old.

- ability to speak English. Note: the quality of life measures have not been validated
yet in non-English speaking populations.

Exclusion Criteria:

- evidence of lower motor neuron injury in the legs

- use of botox in the past 3 months

- pre-existing or confounding neurologic conditions (i.e. brain injury, stroke, HIV)

- acute deep vein thrombosis

- skin wounds in regions where harness or hands provide support

- pregnancy. Note: Persons who are pregnant will not be enrolled as exercise tolerance
is unknown in these women with SCI.

- cognitive conditions that preclude providing informed consent

- ventilator-dependence as study results will be confounded by mobility limitations
imposed by equipment

- persistent orthostatic hypotension (drop of BP >30mmHg in treadmill and harness
equipment)

- hospitalization for myocardial infarction, cardiac surgery or congestive heart failure
exacerbation within 3 months of enrollment in study

- participation in any other concurrent exercise programs.

Note: Use of anti-spasticity and other medications (dose, frequency) will be monitored
throughout training and used as a confounding variable in the analyses.