Spasticity and pain and the improvement of muscle strength in athletes with partial spinal cord injury

Authors

Dariusz Tadeusz Skalski, University of Applied Sciences in Wałcz; Faculty of Physical Culture, Gdansk University of Physical Education and Sport, Gdansk, PolandFollow
Kinga Łosińska, Faculty of Physical Culture, Gdansk University of Physical Education and Sport, Gdansk, PolandFollow
Magdalena Prończuk, Faculty of Physical Culture, Gdansk University of Physical Education and Sport, GdanskFollow
Alicja Markiel, SWPS University of Social Sciences and Humanities in Katowice, PolandFollow
Jarosław Markowski, Department of Laryngology, Faculty of Medical Sciences, Medical University of Silesia in Katowice, PolandFollow
Jan Pilch, Department of Physiological and Medical Sciences, The Jerzy Kukuczka Academy of PhysicalFollow
Joanna Motowidło, Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, PolandFollow
Petr Stastny, Department of Sport Games, Faculty of Physical Education and Sport, Charles University in Prague, the Czech RepublicFollow
Adam Maszczyk, The Jerzy Kukuczka Academy of Physical Education in Katowice; Gdansk University of Physical Education and Sport, Faculty of Physical Culture, Gdansk, PolandFollow

Abstract

Spasticity and chronic pain are common secondary complications following spinal cord injury (SCI), significantly impacting functional recovery and quality of life. Robot-assisted gait training (RAGT) using the Lokomat has been proposed as an effective rehabilitation method to improve motor function and reduce these symptoms. However, the impact of training frequency on rehabilitation outcomes remains unclear, particularly in athletes and physically active individuals. This study aimed to evaluate the effects of Lokomat training on spasticity reduction, pain alleviation, and improvements in gait function and lower limb muscle strength in athletes and physically active individuals with partial SCI. A total of 45 participants (AIS B-D, chronic SCI) were randomly assigned to three groups: group A (n = 15): Lokomat training once per week, group B (n = 15): Lokomat training twice per week, and group C (n = 15): conventional rehabilitation (control group). Spasticity (SCI-SET), pain (VAS), gait function (WISCI II), and muscle strength (LEMS) were assessed at baseline, week 6, and week 12. Group B (2x/week) demonstrated the greatest improvements, with spasticity and pain reductions of ~50% (p < 0.01, large effect sizes). Gait function (WISCI II) and muscle strength (LEMS) significantly improved compared to Group A (1x/week) and Group C (p < 0.05). Group A showed moderate improvements, while Group C exhibited minimal, non-significant changes. Higher Lokomat training frequency (2x/week) significantly enhances spasticity reduction, pain relief, gait function, and muscle strength recovery. These findings support intensive RAGT protocols for SCI rehabilitation, particularly in athletes seeking optimal functional recovery. A minimum of 2 sessions per week is recommended for maximal neuroplasticity-driven recovery, reinforcing the importance of training intensity and consistency in SCI rehabilitation.

Recommended Citation

Skalski DT, Losinska K, Pronczuk M, Markiel A, Markowski J, Pilch J, Motowidlo J, Stastny P, Maszczyk A. Spasticity and pain and the improve-ment of muscle strength in athletes with partial spinal cord injury. Balt J Health Phys Act. 2025;17(1):Article10. DOI: 10.29359/BJHPA.17.1.10

Author ORCID Identifier

Dariusz Tadeusz SKALSKI; ORCID 0000-0001-5128-7724

Kinga ŁOSIŃSKA; ORCID 0009-0009-0227-106X

Magdalena PROŃCZUK; ORCID 0009-0005-1478-3151

Alicja MARKIEL; ORCID 0009-0005-9233-583X

Jarosław MARKOWSKI; ORCID 0000-0003-3416-7354

Jan PILCH; ORCID 0000-0002-2682-4708

Joanna MOTOWIDŁO; ORCID 0009-0009-3261-3702

Petr ŠŤASTNÝ; ORCID 0000-0003-2841-374X

Adam MASZCZYK; ORCID 0000-0001-9139-9747

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.