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Is walking symmetry important for ambulatory patients with spinal cord injury?

Abstract Purpose: To assess and compare the levels of walking symmetry in ambulatory participants with spinal cord injury (SCI) who had different degrees of lesion severity, levels of walking ability, and fall history. In addition, the study explored the relationship between the levels of walking symmetry and variables related to the ability of well-controlled walking of the participants. Study design: Cross-sectional study. Methods: Sixty-six eligible participants were assessed and interviewed for levels of walking symmetry, walking speed, functional endurance, symmetrical lower limb support ability, balance control, and fall history over the last 6 months. Results: Participants walked asymmetrically (85%) similar to those with unilateral impairments (i.e., patients with stroke and amputee, 79–93%). The levels of walking symmetry were significantly correlated to walking speed, functional endurance and balance ability of the participants (p < 0.05). The problem and correlation were particularly apparent in those with the history of multiple falls (79%, r = 0.613–0.765, p < 0.005) Conclusions: The findings confirm problems of asymmetrical walking and the importance of walking symmetry for the ability of well-controlled walking and a risk of multiple falls in ambulatory participants with SCI. Therefore, apart from the levels of independence, the improvement of walking symmetry is crucial for these individuals. Implications for Rehabilitation: Ambulatory individuals with spinal cord injury walked asymmetrically at the same level as those with unilateral impairments such as patients with stroke and amputee. Their levels of walking symmetry were significantly related to the ability of well-controlled walking, particularly in those with the history of multiple falls. The finding confirmed the importance of walking symmetry as a crucial parameter to detect walking improvement and fall risk reduction. Apart from the levels of independence, rehabilitation professionals also need to emphasize on the improvement of symmetrical walking for these patients.