Gait Adaptability Rehabilitation: Perspectives From Individuals With Motor Incomplete Spinal Cord Injury

BACKGROUND AND PURPOSE: Following motor incomplete spinal cord injury (SCI), gait adaptability, which is the ability to modify one's gait pattern in response to task/environmental demands, is likely impaired. Despite rehabilitation, many individuals with motor incomplete SCI face ongoing walking challenges and view safe walking as an unmet goal. This study explored the perceived importance and appropriateness of addressing gait adaptability during SCI rehabilitation from the perspectives of community-dwelling adults with subacute, motor incomplete SCI. METHODS: A qualitative study using semi-structured interviews was conducted. The interview guide was structured around the Capability-Opportunity-Motivation-Behaviour (COM-B) model, which examines the physical, social, and psychological factors influencing behavior. Questions queried participants' perspectives on current rehabilitation practices aimed at improving gait adaptability. Interviews were conducted 3 to 6 months post-inpatient discharge, audio-recorded, transcribed verbatim, and analyzed using interpretive description. RESULTS: Fourteen individuals with motor incomplete SCI who completed walking training in inpatient rehabilitation were interviewed (9 males/men, 5 females/women). Three themes highlighting participant perceptions were identified: (1) gait adaptability is important for community reintegration, (2) perceived gait adaptability training and assessment practices: training is variable, with progress commonly measured by distance, and (3) real-world walking is complex: Training should reflect where people walk. Each theme included 2 subthemes, with participants highlighting the importance of real-world walking exposure, outdoor practice, and the role of personal goals in driving motivation. DISCUSSION AND CONCLUSIONS: This study highlights the perceived importance of gait adaptability training for individuals with motor incomplete SCI, emphasizing its role in fostering confidence and independence post-inpatient discharge.