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Locomotor Training for Spinal Cord Injury: Will You Be Able to Walk Again?

understanding locomotor training for spinal cord injury

Is locomotor training for spinal cord injury recovery right for you?

To help you find out, this article will go over everything you need to know about locomotor training for spinal cord injury patients.

What is Locomotor Training?

Locomotor training is a type of physical therapy that specifically focuses on recovering the ability to walk.

The 4 guiding principles of locomotor training include:

  1. Making sure that you’re bearing most of your weight on the legs rather than relying on the upper body
  2. Enhancing sensory input for each activity
  3. Ensuring proper kinematics (positioning of the body during motion)
  4. Optimizing independence

One method used in locomotor training for spinal cord injury patients is anti-gravity treadmill training.

The patient walks on the treadmill while suspended in a harness which supports their body weight. This way, they can practice taking steps without bearing their full body weight on the joints.

As patients improve, the amount of weight being supported can be adjusted.

Another method used in locomotor training for spinal cord injury patients is overground walking training.

Rather than walking on equipment or in a pool, patients practice walking on the ground with or without the assistance of walking aids and orthotics.

Benefits of Locomotor Training for Spinal Cord Injury Patients

effects of  locomotor training for spinal cord injury


Benefits of locomotor training after spinal cord injury include:

  • Improved limb coordination
  • Enhanced step symmetry
  • Increased walking speed
  • Increased endurance
  • Improved balance
  • Reduced systolic blood pressure and heart rate
  • Improved breathing stability

Even in instances where spinal cord injury patients aren’t improving their walking, they are practicing stimulating and bearing weight on their bones and muscles.

This improves circulation, prevents muscle atrophy, and increases metabolic rate for optimal functioning.

Why Locomotor Training After Spinal Cord Injury Works

Locomotor training for spinal cord injury patients works because it focuses on optimizing neuroplasticity.

Neuroplasticity is the central nervous system’s ability to adapt.

After a spinal cord injury, you have to relearn how to walk.

Locomotor training is task-specific and emphasizes massed practice. It works on stimulating the muscles below your level of injury to promote the rewiring of neural circuits in the spinal cord.

The central nervous system is constantly reorganizing itself based on demand. The more you repeat a weak movement, the more circuit reorganization and strengthening occur.

Check out the video below to see spinal cord injury locomotion training in action!

Dr. Claudia Angeli explains how neuroplasticity makes the impossible possible. However, you need to put in the work by practicing weak movements repeatedly until they become automatic.

Does Locomotor Training Work for All SCI Patients?

Not every spinal cord injury patient will be able to participate in locomotor training.

For example, if you’re paralyzed from the neck down, rehabilitation therapy will prioritize recovering arm functions.

Some movement in the legs is required, which means that incomplete spinal cord injury patients with paraplegia will benefit most from locomotor training.

However, there is still hope for complete spinal cord injury patients! When combined with electrical stimulation, locomotor training can get individuals with motor complete SCIs on their feet again.

Combining Locomotor Training with Electrical Stimulation

After a spinal cord injury, connections between your brain and body can’t pass through the injury site.

Epidural electrical stimulation is when an electrode array is implanted on your lower spinal column.

It works around the SCI and delivers electric currents to areas below the injury site.

The electric currents mimic brain signals and excite electrons to enable movement.

Learn more about epidural stimulation for spinal cord injury recovery »

Does Timing of Locomotor Training After Spinal Cord Injury Matter?

does timing of locomotor training after spinal cord injury matter


While the spinal cord always has plasticity, it experiences heightened levels of neuroplasticity following a traumatic event like SCI.

Therefore, it’s suggested that adaptations will occur quicker if you pursue recovery earlier rather than later.

However, neuroplasticity never goes away.

Even if you haven’t noticed improvements in years, there’s always hope for recovery because the central nervous system is constantly rewiring itself based on your actions.

As long as you’re putting in the work, there’s always hope for recovery.

Read more about spinal cord injury recovery time »

Locomotor Training After Spinal Cord Injury: Key Points

spinal cord injury locomotor training focuses on promoting neuroplasticity


Locomotor training focuses on recovering one’s ability to walk after a spinal cord injury.

It works because the spinal cord has neuroplasticity and can rewire itself when stimulated by task-specific, high-repetition movements.

Thousands of repetitions are required to promote circuit reorganization in the spinal cord, so it’s important to be patient and trust in the process.

Hopefully, this article helped you better understand exactly what locomotor training is and how it can help improve walking ability after spinal cord injury. Good luck!

Featured image: ©iStock/KatarzynaBialasiewicz

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