Effects of lower limb loading during sit-to-stand on mobility of ambulatory individuals with spinal cord injury: a single-session and two-week randomized controlled trial

Background The decreased rehabilitation length suggests the need for practical training strategies enabling the distribution of effective services for ambulatory individuals with spinal cord injury (SCI) in various settings.Objectives This randomized controlled trial compared the effects of lower limb loading during sit-to-stand (LLL-STS) training with verbal versus visual feedback on the mobility of ambulatory individuals with SCI, following a single-session and two-week training.Methods Participants, mostly with chronic SCI (average post-injury time > 5 years), were involved in the LLL-STS training with verbal command (active control intervention group) or visual feedback (experimental intervention group) for 20 min, followed by overground walking training for 10 min, 5 days/week over 2 weeks. Mobility outcomes, including walking speed using the 10-m walk test, timed up and go test (TUG), and five‑times sit-to-stand test, were assessed before and after the first training session (31 participants/group) and after 2 weeks (15 participants/group). The LLL-STS and the 6-min walk test (6MWT) data were also assessed for those who completed the single session and two-week training programs, respectively.Results Participants in the active control intervention group improved preferred speed (0.03 ± 0.07 m/s) and TUG data (−2.1 ± 4.9 s), while those in the experimental intervention group increased the sit-to-stand duration (0.9 ± 1.3 s), decreased the maximal LLL-STS (−1.4 ± 3.2% body-weight), and improved TUG data significantly (−1.4 ± 1.9 s, p < .05) following a single training session. After 2-week training programs, participants in both groups improved the 6MWT data (26.2 ± 31.3 m and 19.2 ± 23.3 m for the active control and experimental intervention groups, respectively). Participants in the experimental intervention training group also improved fastest speed (0.06 ± 0.07 m/s) and TUG data (−4.0 ± 5.1 s, p < .05). However, there were no significant differences between the groups (p > .05).Conclusion The practical LLL-STS training programs, both with verbal and visual feedback, can be applied as an alternative practical strategy to promote mobility of ambulatory individuals with SCI in various clinical and home-based settings.