We documented the impact of 1 year of underwater treadmill training and supplemental overground walk training in five adults with chronic motor-complete SCI (cSCI) who had not undergone programmed epidural spinal cord stimulation (eSCS).

Regular exposure to self-initiated treadmill walking in water, a unique sensorimotor exercise setting that makes stepping movements easier to perform, may capitalize on the adaptability of the neuromuscular system and enhance locomotor function in persons with cSCI who have not undergone eSCS. In our study, a combined aquatics- and land-based approach to gait training was employed over a 12-month period that featured underwater treadmill training and supplemental overground walk training.

Inclusion Criteria

• At least 21 years of age
• Presence of traumatic or non-traumatic spinal cord injury for at least 1 year
• Medical diagnosis of paraplegia (T1 or below)

Exclusion Criteria

• Presence of complex comorbidities that could limit involvement in training activities
• Surgical implantation or removal of a medical device six months prior to training
• Skin breakdown
• Use of electrical implants to promote ambulation