{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T16:41:14Z","timestamp":1781541674949,"version":"3.54.5"},"reference-count":54,"publisher":"Oxford University Press (OUP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,2,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>In individuals with motor incomplete spinal cord injury (SCI), ambulatory function determined in the clinical setting is related to specific measures of body structure and function and activity limitations, although few studies have quantified the relationship of these variables with daily stepping (steps\/day).<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of this study was to quantify daily stepping in ambulatory individuals with SCI and its relationship with clinical walking performance measures and specific demographics, impairments, and activity limitations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A cross-sectional study was performed to estimate relationships among clinical variables to daily stepping in self-identified community versus non\u2013community (household) walkers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Average daily stepping was determined in 50 people with chronic, motor incomplete SCI. Data for clinical and self-report measures of walking performance also were collected, and their associations with daily stepping were analyzed using correlation and receiver operating characteristic (ROC) analyses. Relationships between daily stepping and the measures of demographics, impairments, and activity limitations were identified using correlation and regression analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The ROC analyses revealed a significant discriminative ability between self-reported community and non\u2013community walkers using clinical gait measures and daily stepping. Stepping activity generally was low throughout the sample tested, however, with an average of approximately 2,600 steps\/day. Knee extension strength (force-generating capacity) and static balance were the primary variables related to daily stepping, with metabolic efficiency and capacity and balance confidence contributing to a lesser extent.<\/jats:p><\/jats:sec><jats:sec><jats:title>Limitations<\/jats:title><jats:p>The small sample size and use of specific impairment-related measures were potential limitations of the study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Daily stepping is extremely limited in individuals with incomplete SCI, with a potentially substantial contribution of impairments in knee extension strength and balance.<\/jats:p><\/jats:sec>","DOI":"10.2522\/ptj.20090064","type":"journal-article","created":{"date-parts":[[2009,12,19]],"date-time":"2009-12-19T02:32:39Z","timestamp":1261189959000},"page":"224-235","source":"Crossref","is-referenced-by-count":35,"title":["Daily Stepping in Individuals With Motor Incomplete Spinal Cord Injury"],"prefix":"10.1093","volume":"90","author":[{"given":"Poonam","family":"Saraf","sequence":"first","affiliation":[{"name":"P. Saraf, PT, MSPT, is Physical Therapist, St. Francis Hospital, Evanston, Illinois."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam R.","family":"Rafferty","sequence":"additional","affiliation":[{"name":"M.R. Rafferty, PT, DPT, is Research and Staff Physical Therapist, Rehabilitation Institute of Chicago, Chicago, Illinois."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"Moore","sequence":"additional","affiliation":[{"name":"J.L. Moore, PT, MPT, NCS, is Research Physical Therapist, Rehabilitation Institute of Chicago."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer H.","family":"Kahn","sequence":"additional","affiliation":[{"name":"J.H. Kahn, PT, DPT, NCS, is Research Physical Therapist, Rehabilitation Institute of Chicago."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Hendron","sequence":"additional","affiliation":[{"name":"K. Hendron is a student physical therapist at the University of Illinois at Chicago, Chicago, Illinois."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristan","family":"Leech","sequence":"additional","affiliation":[{"name":"K. Leech is a student physical therapist at the University of Illinois at Chicago."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. George","family":"Hornby","sequence":"additional","affiliation":[{"name":"T.G. Hornby, PT, MPT, PhD, is Assistant Professor, Department of Physical Therapy, University of Illinois at Chicago, 1919 W Taylor St, Room 413, Chicago, IL 60612 (USA), and Research Scientist, Rehabilitation Institute of Chicago."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","reference":[{"key":"2019123012282764400_B1","volume-title":"2004 Annual Statistical Report for the Model Spinal Cord Injury Care Systems","year":"2004"},{"key":"2019123012282764400_B2","article-title":"Annual Report for the Model Spinal Cord Injury Care Systems","year":"2008"},{"key":"2019123012282764400_B3","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1038\/sj.sc.3101876","article-title":"Cross-cultural differences in preference for recovery of mobility among spinal cord injury rehabilitation professionals","volume":"44","author":"Ditunno","year":"2006","journal-title":"Spinal Cord"},{"key":"2019123012282764400_B4","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1038\/sj.sc.3102161","article-title":"Coronary heart disease in individuals with spinal cord injury: assessment of risk factors","volume":"46","author":"Bauman","year":"2008","journal-title":"Spinal Cord"},{"key":"2019123012282764400_B5","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1038\/sj.sc.3101757","article-title":"Spasticity after spinal cord injury","volume":"43","author":"Adams","year":"2005","journal-title":"Spinal Cord"},{"key":"2019123012282764400_B6","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1097\/BRS.0b013e3181626ab0","article-title":"Clinical factors that affect walking level and performance in chronic spinal cord lesion patients","volume":"33","author":"Scivoletto","year":"2008","journal-title":"Spine"},{"key":"2019123012282764400_B7","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1038\/sj.sc.3101569","article-title":"Level walking and ambulatory capacity in persons with incomplete spinal cord injury: relationship with muscle strength","volume":"42","author":"Kim","year":"2004","journal-title":"Spinal Cord"},{"key":"2019123012282764400_B8","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/0003-9993(94)90034-5","article-title":"Motor and sensory recovery following incomplete paraplegia","volume":"75","author":"Waters","year":"1994","journal-title":"Arch Phys Med Rehabil"},{"key":"2019123012282764400_B9","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1038\/sj.sc.3101167","article-title":"Functional community ambulation requirements in incomplete spinal cord injured subjects","volume":"39","author":"Lapointe","year":"2001","journal-title":"Spinal Cord"},{"key":"2019123012282764400_B10","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1177\/1545968306295556","article-title":"The evolution of walking-related outcomes over the first 12 weeks of rehabilitation for incomplete traumatic spinal cord injury: the multicenter randomized Spinal Cord Injury Locomotor Trial","volume":"21","author":"Dobkin","year":"2007","journal-title":"Neurorehabil Neural Repair"},{"key":"2019123012282764400_B11","doi-asserted-by":"crossref","first-page":"282","DOI":"10.2522\/ptj.20060142","article-title":"Determinants of satisfaction with community reintegration in older adults with chronic stroke: role of balance self-efficacy","volume":"87","author":"Pang","year":"2007","journal-title":"Phys Ther"},{"key":"2019123012282764400_B12","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1080\/09638280600787047","article-title":"Determinants of depression in chronic stroke: a prospective cohort study","volume":"29","author":"van de Port","year":"2007","journal-title":"Disabil Rehabil"},{"key":"2019123012282764400_B13","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1161\/01.STR.26.6.982","article-title":"Classification of walking handicap in the stroke population","volume":"26","author":"Perry","year":"1995","journal-title":"Stroke"},{"key":"2019123012282764400_B14","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.apmr.2003.05.002","article-title":"Community ambulation after stroke: how important and obtainable is it and what measures appear predictive?","volume":"85","author":"Lord","year":"2004","journal-title":"Arch Phys Med Rehabil"},{"key":"2019123012282764400_B15","doi-asserted-by":"crossref","first-page":"2096","DOI":"10.1161\/STROKEAHA.106.475921","article-title":"Improvements in speed-based gait classifications are meaningful","volume":"38","author":"Schmid","year":"2007","journal-title":"Stroke"},{"key":"2019123012282764400_B16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2165\/00007256-200434010-00001","article-title":"How many steps\/day are enough? Preliminary pedometer indices for public health","volume":"34","author":"Tudor-Locke","year":"2004","journal-title":"Sports Med"},{"key":"2019123012282764400_B17","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1093\/ptj\/86.8.1137","article-title":"Using activity monitors to measure physical activity in free-living conditions","volume":"86","author":"Berlin","year":"2006","journal-title":"Phys Ther"},{"key":"2019123012282764400_B18","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1097\/00005768-200203000-00002","article-title":"Microprocessor-based ambulatory activity monitoring in stroke patients","volume":"34","author":"Macko","year":"2002","journal-title":"Med Sci Sports Exerc"},{"key":"2019123012282764400_B19","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1093\/ptj\/85.12.1356","article-title":"Locomotor training progression and outcomes after incomplete spinal cord injury","volume":"85","author":"Behrman","year":"2005","journal-title":"Phys Ther"},{"key":"2019123012282764400_B20","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1097\/NPT.0b013e3181838291","article-title":"Beyond gait speed: a case report of a multidimensional approach to locomotor rehabilitation outcomes in incomplete spinal cord injury","volume":"32","author":"Bowden","year":"2008","journal-title":"J Neurol Phys Ther"},{"key":"2019123012282764400_B21","volume-title":"International Standards for Neurological and Functional Classification of Spinal Cord Injury","year":"1994"},{"key":"2019123012282764400_B22","doi-asserted-by":"crossref","first-page":"1552","DOI":"10.1016\/j.apmr.2004.12.026","article-title":"Reduced ambulatory activity after stroke: the role of balance, gait, and cardiovascular fitness","volume":"86","author":"Michael","year":"2005","journal-title":"Arch Phys Med Rehabil"},{"key":"2019123012282764400_B23","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1093\/ptj\/67.2.206","article-title":"Interrater reliability of a modified Ashworth scale of muscle spasticity","volume":"67","author":"Bohannon","year":"1987","journal-title":"Phys Ther"},{"key":"2019123012282764400_B24","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.apmr.2004.01.033","article-title":"A physiologically based clinical measure for spastic reflexes in spinal cord injury","volume":"86","author":"Benz","year":"2005","journal-title":"Arch Phys Med Rehabil"},{"key":"2019123012282764400_B25","doi-asserted-by":"crossref","first-page":"611","DOI":"10.3171\/jns.1979.50.5.0611","article-title":"Neurological prognosis after traumatic quadriplegia: three-year experience of the California Regional Spinal Cord Injury Care System","volume":"50","author":"Maynard","year":"1979","journal-title":"J Neurosurg"},{"key":"2019123012282764400_B26","first-page":"762","article-title":"Spinal cord injury: prognosis for ambulation based on quadriceps recovery","volume":"30","author":"Crozier","year":"1992","journal-title":"Paraplegia"},{"key":"2019123012282764400_B27","doi-asserted-by":"crossref","first-page":"27","DOI":"10.2340\/1650197719952736","article-title":"The Balance Scale: reliability assessment with elderly residents and patients with an acute stroke","volume":"27","author":"Berg","year":"1995","journal-title":"Scand J Rehabil Med"},{"issue":"288","key":"2019123012282764400_B28","first-page":"87","article-title":"Gait performance after spinal cord injury","author":"Waters","year":"1993","journal-title":"Clin Orthop Relat Res"},{"key":"2019123012282764400_B29","volume-title":"ACSM's Guidelines for Exercise Testing and Prescription","year":"2000","edition":"6th ed."},{"key":"2019123012282764400_B30","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1016\/j.medengphy.2005.07.017","article-title":"Accuracy, reliability, and validity of a spatiotemporal gait analysis system","volume":"28","author":"Barker","year":"2006","journal-title":"Med Eng Phys"},{"key":"2019123012282764400_B31","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/S0167-5877(00)00115-X","article-title":"Principles and practical application of the receiver-operating characteristic analysis for diagnostic tests","volume":"45","author":"Greiner","year":"2000","journal-title":"Prev Vet Med"},{"key":"2019123012282764400_B32","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1161\/01.STR.0000206441.79646.49","article-title":"Predicting mortality in spontaneous intracerebral hemorrhage: can modification to original score improve the prediction?","volume":"37","author":"Godoy","year":"2006","journal-title":"Stroke"},{"key":"2019123012282764400_B33","volume-title":"Applied Regression Analysis and Other Multivariable Methods","author":"Kleinbaum","year":"1997","edition":"3rd ed."},{"key":"2019123012282764400_B34","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1682\/JRRD.2006.03.0033","article-title":"Step Activity Monitor: accuracy and test-retest reliability in persons with incomplete spinal cord injury","volume":"44","author":"Bowden","year":"2007","journal-title":"J Rehabil Res Dev"},{"key":"2019123012282764400_B35","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1136\/jnnp.2005.074294","article-title":"Community walking activity in neurological disorders with leg weakness","volume":"77","author":"Busse","year":"2006","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"2019123012282764400_B36","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.apmr.2006.10.025","article-title":"Determinants of walking function after stroke: differences by deficit severity","volume":"88","author":"Patterson","year":"2007","journal-title":"Arch Phys Med Rehabil"},{"key":"2019123012282764400_B37","doi-asserted-by":"crossref","first-page":"3243","DOI":"10.1016\/j.jbiomech.2008.07.031","article-title":"Muscle contributions to support and progression over a range of walking speeds","volume":"41","author":"Liu","year":"2008","journal-title":"J Biomech"},{"key":"2019123012282764400_B38","doi-asserted-by":"crossref","first-page":"567","DOI":"10.2340\/16501977-0090","article-title":"Walking tasks encountered by urban-dwelling adults and persons with incomplete spinal cord injuries","volume":"39","author":"Musselman","year":"2007","journal-title":"J Rehabil Med"},{"key":"2019123012282764400_B39","doi-asserted-by":"crossref","first-page":"1733","DOI":"10.1152\/jn.00019.2005","article-title":"Adapting locomotion to different surface compliances: neuromuscular responses and changes in movement dynamics","volume":"94","author":"Marigold","year":"2005","journal-title":"J Neurophysiol"},{"key":"2019123012282764400_B40","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1007\/s002210050743","article-title":"Adaptation of the walking pattern to uphill walking in normal and spinal-cord injured subjects","volume":"126","author":"Leroux","year":"1999","journal-title":"Exp Brain Res"},{"key":"2019123012282764400_B41","doi-asserted-by":"crossref","first-page":"B144","DOI":"10.1093\/gerona\/57.4.B144","article-title":"Functionally relevant thresholds of quadriceps femoris strength","volume":"57","author":"Ploutz-Snyder","year":"2002","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"2019123012282764400_B42","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1016\/j.apmr.2008.09.562","article-title":"Isometric muscle function of knee extensors and the relation with functional performance in patients with stroke","volume":"90","author":"Gerrits","year":"2009","journal-title":"Arch Phys Med Rehabil"},{"key":"2019123012282764400_B43","doi-asserted-by":"crossref","first-page":"73","DOI":"10.2522\/ptj.20070234","article-title":"Lower-extremity strength differences predict activity limitations in people with chronic stroke","volume":"89","author":"Kluding","year":"2009","journal-title":"Phys Ther"},{"key":"2019123012282764400_B44","first-page":"213","article-title":"Energy expenditure of the paraplegic gait: comparison between different walking aids and normal subjects","volume":"26","author":"Ulkar","year":"2003","journal-title":"Int J Rehabil Res"},{"key":"2019123012282764400_B45","first-page":"811","article-title":"Determinants of gait performance following spinal cord injury","volume":"70","author":"Waters","year":"1989","journal-title":"Arch Phys Med Rehabil"},{"key":"2019123012282764400_B46","volume-title":"Adult Hemiplegia: Evaluation and Treatment","author":"Bobath","year":"1990","edition":"3rd ed."},{"key":"2019123012282764400_B47","unstructured":"Bobath Centre . Available at: http:\/\/www.bobath.org.uk\/contact.html. 2009. Accessed June 10, 2009."},{"key":"2019123012282764400_B48","first-page":"5","article-title":"Pharmacological interventions for spasticity following spinal cord injury: results of a Cochrane systematic review","volume":"42","author":"Taricco","year":"2006","journal-title":"Eura Medicophys"},{"issue":"3 pt 1","key":"2019123012282764400_B49","doi-asserted-by":"crossref","first-page":"747","DOI":"10.2466\/pms.2000.90.3.747","article-title":"A broad range of forces is encompassed by the maximum manual muscle test grade of five","volume":"90","author":"Bohannon","year":"2000","journal-title":"Percept Mot Skills"},{"key":"2019123012282764400_B50","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1191\/026921599677595404","article-title":"A review of the properties and limitations of the Ashworth and modified Ashworth scales as measures of spasticity","volume":"13","author":"Pandyan","year":"1999","journal-title":"Clin Rehabil"},{"key":"2019123012282764400_B51","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1097\/01.NPT.0000282515.01717.8d","article-title":"Evidence-based exercise prescription for individuals with spinal cord injury","volume":"29","author":"Myslinski","year":"2005","journal-title":"J Neurol Phys Ther"},{"key":"2019123012282764400_B52","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1097\/01.NPT.0000282514.94093.c6","article-title":"Exercise as a health-promoting activity following spinal cord injury","volume":"29","author":"Nash","year":"2005","journal-title":"J Neurol Phys Ther"},{"key":"2019123012282764400_B53","doi-asserted-by":"crossref","first-page":"149","DOI":"10.2522\/ptj.20090119","article-title":"Sit-to-stand movement as a performance-based measure for patients with total knee arthroplasty","volume":"90","author":"Boonstra","year":"2010","journal-title":"Phys Ther"},{"key":"2019123012282764400_B54","doi-asserted-by":"crossref","first-page":"269","DOI":"10.2522\/ptj.20090062","article-title":"Can strength training predictably improve gait kinematics? A pilot study on the effects of hip and knee extensor strengthening on lower-extremity alignment in cerebral palsy","volume":"90","author":"Damiano","year":"2010","journal-title":"Phys Ther"}],"container-title":["Physical Therapy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ptj\/article-pdf\/90\/2\/224\/31643003\/ptj0224.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ptj\/article-pdf\/90\/2\/224\/31643003\/ptj0224.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T22:37:36Z","timestamp":1739486256000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ptj\/article\/90\/2\/224\/2737848"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,2,1]]},"references-count":54,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2010,2,1]]}},"URL":"https:\/\/doi.org\/10.2522\/ptj.20090064","relation":{},"ISSN":["0031-9023","1538-6724"],"issn-type":[{"value":"0031-9023","type":"print"},{"value":"1538-6724","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,2,1]]}}}