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Article: Surgical intervention combined with weight-bearing walking training improves neurological recoveries in 320 patients with clinically complete spinal cord injury: a prospective self-controlled study

TitleSurgical intervention combined with weight-bearing walking training improves neurological recoveries in 320 patients with clinically complete spinal cord injury: a prospective self-controlled study
Authors
KeywordsAmerican Spinal Injury Association Impairment Scale–A
functional recovery
human
intramedullary decompression
spinal cord injury
Issue Date2020
PublisherMedknow Publications and Media Pvt. Ltd. The Journal's web site is located at http://www.nrronline.org/
Citation
Neural Regeneration Research, 2020, v. 16 n. 5, p. 820-829 How to Cite?
AbstractAlthough a large number of trials in the SCI field have been conducted, few proven gains have been realized for patients. In the present study, we determined the efficacy of a novel combination treatment involving surgical intervention and long-term weight-bearing walking training in spinal cord injury (SCI) subjects clinically diagnosed as complete or American Spinal Injury Association Impairment Scale (AIS) Class A (AIS-A). A total of 320 clinically complete SCI subjects (271 male and 49 female), aged 16–60 years, received early (≤ 7 days, n = 201) or delayed (8–30 days, n = 119) surgical interventions to reduce intraspinal or intramedullary pressure. Fifteen days post-surgery, all subjects received a weight-bearing walking training with the “Kunming Locomotion Training Program (KLTP)” for a duration of 6 months. The neurological deficit and recovery were assessed using the AIS scale and a 10-point Kunming Locomotor Scale (KLS). We found that surgical intervention significantly improved AIS scores measured at 15 days post-surgery as compared to the pre-surgery baseline scores. Significant improvement of AIS scores was detected at 3 and 6 months and the KLS further showed significant improvements between all pair-wise comparisons of time points of 15 days, 3 or 6 months indicating continued improvement in walking scores during the 6-month period. In conclusion, combining surgical intervention within 1 month post-injury and weight-bearing locomotor training promoted continued and statistically significant neurological recoveries in subjects with clinically complete SCI, which generally shows little clinical recovery within the first year after injury and most are permanently disabled. This study was approved by the Science and Research Committee of Kunming General Hospital of PLA and Kunming Tongren Hospital, China and registered at ClinicalTrials.gov (Identifier: NCT04034108) on July 26, 2019.
Persistent Identifierhttp://hdl.handle.net/10722/298796
ISSN
2020 Impact Factor: 5.135
2020 SCImago Journal Rankings: 0.930
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLiu, Y-
dc.contributor.authorXie, JX-
dc.contributor.authorNiu, F-
dc.contributor.authorXu, Z-
dc.contributor.authorTan, P-
dc.contributor.authorShen, C-
dc.contributor.authorGao, H-
dc.contributor.authorLiu, S-
dc.contributor.authorMa, Z-
dc.contributor.authorSo, KF-
dc.contributor.authorWu, W-
dc.contributor.authorChen, C-
dc.contributor.authorGao, S-
dc.contributor.authorXu, XM-
dc.contributor.authorZhu, H-
dc.date.accessioned2021-04-12T03:03:29Z-
dc.date.available2021-04-12T03:03:29Z-
dc.date.issued2020-
dc.identifier.citationNeural Regeneration Research, 2020, v. 16 n. 5, p. 820-829-
dc.identifier.issn1673-5374-
dc.identifier.urihttp://hdl.handle.net/10722/298796-
dc.description.abstractAlthough a large number of trials in the SCI field have been conducted, few proven gains have been realized for patients. In the present study, we determined the efficacy of a novel combination treatment involving surgical intervention and long-term weight-bearing walking training in spinal cord injury (SCI) subjects clinically diagnosed as complete or American Spinal Injury Association Impairment Scale (AIS) Class A (AIS-A). A total of 320 clinically complete SCI subjects (271 male and 49 female), aged 16–60 years, received early (≤ 7 days, n = 201) or delayed (8–30 days, n = 119) surgical interventions to reduce intraspinal or intramedullary pressure. Fifteen days post-surgery, all subjects received a weight-bearing walking training with the “Kunming Locomotion Training Program (KLTP)” for a duration of 6 months. The neurological deficit and recovery were assessed using the AIS scale and a 10-point Kunming Locomotor Scale (KLS). We found that surgical intervention significantly improved AIS scores measured at 15 days post-surgery as compared to the pre-surgery baseline scores. Significant improvement of AIS scores was detected at 3 and 6 months and the KLS further showed significant improvements between all pair-wise comparisons of time points of 15 days, 3 or 6 months indicating continued improvement in walking scores during the 6-month period. In conclusion, combining surgical intervention within 1 month post-injury and weight-bearing locomotor training promoted continued and statistically significant neurological recoveries in subjects with clinically complete SCI, which generally shows little clinical recovery within the first year after injury and most are permanently disabled. This study was approved by the Science and Research Committee of Kunming General Hospital of PLA and Kunming Tongren Hospital, China and registered at ClinicalTrials.gov (Identifier: NCT04034108) on July 26, 2019.-
dc.languageeng-
dc.publisherMedknow Publications and Media Pvt. Ltd. The Journal's web site is located at http://www.nrronline.org/-
dc.relation.ispartofNeural Regeneration Research-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectAmerican Spinal Injury Association Impairment Scale–A-
dc.subjectfunctional recovery-
dc.subjecthuman-
dc.subjectintramedullary decompression-
dc.subjectspinal cord injury-
dc.titleSurgical intervention combined with weight-bearing walking training improves neurological recoveries in 320 patients with clinically complete spinal cord injury: a prospective self-controlled study-
dc.typeArticle-
dc.identifier.emailSo, KF: hrmaskf@hku.hk-
dc.identifier.authoritySo, KF=rp00329-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.4103/1673-5374.297080-
dc.identifier.pmid33229715-
dc.identifier.scopuseid_2-s2.0-85097096502-
dc.identifier.hkuros321992-
dc.identifier.volume16-
dc.identifier.issue5-
dc.identifier.spage820-
dc.identifier.epage829-
dc.identifier.isiWOS:000595801900003-
dc.publisher.placeChina-

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