Patient and Clinician Perceptions of Safe Ambulation in Incomplete Spinal Cord Injury

Walking Index for Spinal Cord Injury II (WISCI II), which assessed walking independence and the need for assistive devices. Scores ranged from 0 to 20 based on the amount of physical assistance, use of braces, and walking aids required to walk 10 meters. In addition to the measured WISCI II score, patient-rated WISCI II (P13) and therapist-rated WISCI II (T5) levels were recorded to reflect the levels at which the individual and the clinician perceived safe ambulation.

Assessment of lower extremity muscle strength using the American Spinal Injury Association (ASIA) Lower Extremity Motor Score (LEMS)

Ten-Meter Walking Test for overground walking speed assessment

Timed Up and Go Test overground walking assessment

Berg Balance Scale for balance assessment

Spinal Cord Independence Measure (SCIM III) for activity of daily living assessment

World Health Organization Quality of Life Scale-Short Form (WHOQOL - BREF) for quality of life assessment

A questionnaire evaluating user satisfaction with assistive devices in terms of performance and service quality.

The RHDS/SF assessed patients' self-perceived readiness for hospital discharge and ability to manage care needs at home, with scores from 0 to 10 where higher scores indicated greater readiness.

The AAQ-II measured psychological flexibility and experiential avoidance using nine items rated from 1 (never true) to 7 (always true), with lower scores indicating greater flexibility.

The SCLCSQ assessed coping strategies in individuals with spinal cord injury across three domains-acceptance, social confidence, and fighting spirit-using 12 items rated on a 4-point scale.

P1 assessed the patient's fear of falling during daily ambulation with their preferred assistive device or orthosis on a 0-100 mm visual analog scale.

P2 assessed the patient's perceived risk of falling during daily ambulation with their preferred assistive device or orthosis on a 0-100 mm visual analog scale.

Time Frame: Baseline (single time point, within 24-month recruitment period)

P3 assessed perceived overall mobility compared to the patient's self-perceived maximum potential on a 0-100 mm visual analog scale.

P4 assessed the degree to which the most appropriate assistive device or orthosis was used during upright daily activities on a 0-100 mm visual analog scale.

P5 assessed comfort when using assistive devices or orthoses for walking or standing on a 0-100 mm visual analog scale.

P6 assessed perceived difficulty when using assistive devices or orthoses for walking or standing on a 0-100 mm Visual Analog Scale.

P7 assessed fatigue experienced after using assistive devices or orthoses for 30-40 minutes in a single session on a 0-100 mm Visual Analog Scale.

P8 assessed the proportion of upright daily activities performed with walking aids on a 0-100 mm Visual Analog Scale.

P9 assessed the proportion of upright daily activities performed with seating aids such as wheelchairs on a 0-100 mm Visual Analog Scale.

P10 recorded the average daily hours spent standing as reported by the patient.

P11 recorded the average daily hours spent sitting as reported by the patient.

P12 recorded the average daily hours spent lying down as reported by the patient.

P14 recorded the assistive device or orthosis planned for indoor ambulation after discharge, adapted from Walking Index for Spinal Cord Injury II categories.

P15 recorded the assistive device or orthosis planned for outdoor ambulation after discharge, adapted from Walking Index for Spinal Cord Injury II categories.

P16 recorded the type of assistive device or orthosis used for outdoor ambulation over short distances during therapy, adapted from Walking Index for Spinal Cord Injury II categories.

P17 recorded the number of falls within the past year in therapy and non-therapy settings as self-reported by the patient.

P18 recorded the number of near-fall incidents within the past year in therapy and non-therapy settings as self-reported by the patient.

P19 recorded the assistive device or orthosis expected to be used in daily life after discharge, adapted from Walking Index for Spinal Cord Injury II categories.

T1 assessed the therapist's perception of the patient's fall risk during daily ambulation with their preferred assistive device or orthosis on a 0-100 mm Visual Analog Scale.

T2 assessed the therapist's perception of the patient's overall mobility compared to their maximum potential on a 0-100 mm Visual Analog Scale.

T3 assessed the therapist's perception of the patient's mobility level compared to a similar person without injury on a 0-100 mm Visual Analog Scale.

T4 assessed the degree to which the patient used the most appropriate assistive device or orthosis during upright daily activities without therapist guidance, on a 0-100 mm Visual Analog Scale.

T6 recorded the type of assistive device or orthosis used for outdoor ambulation over short distances during therapy, adapted from Walking Index for Spinal Cord Injury II categories.

T7 recorded the assistive device or orthosis recommended for daily life after discharge, adapted from Walking Index for Spinal Cord Injury II categories.