Walking Stability During Normal Walking and Its Association with Slip Intensity Among Individuals with Incomplete Spinal Cord Injury.


Journal

PM & R : the journal of injury, function, and rehabilitation
ISSN: 1934-1563
Titre abrégé: PM R
Pays: United States
ID NLM: 101491319

Informations de publication

Date de publication:
03 2019
Historique:
received: 04 04 2018
accepted: 11 07 2018
pubmed: 24 7 2018
medline: 24 4 2020
entrez: 24 7 2018
Statut: ppublish

Résumé

Ambulatory individuals with incomplete spinal cord injury (iSCI) experience frequent falls suggesting impairments in their balance control. Individuals with iSCI are more stable during normal walking as compared to able-bodied (AB) individuals; however, it is not known whether this increased stability helps prevent hazardous slips. To compare walking stability during normal walking between iSCI and AB individuals, and to study the association between stability during normal walking and the intensity of an unexpected slip perturbation. Cross-sectional. Biomechanics of Balance and Movement lab, University of Saskatchewan, Saskatoon. Twenty iSCI (15 men; age: M = 60.05, SD = 17.77 years) and 16 (12 men; age: M = 58.92, SD = 17.10 years) AB individuals. Stability measures during unperturbed walking at a self-selected speed were collected from all the participants. Additionally, stability measures were also collected from 10 of the AB participants walking at a slower speed. An unexpected slip perturbation was recorded in all participants during a self-selected speed trial and peak-slip heel velocity post slip was recorded. Measures of stability: ankle co-contraction, required coefficient of friction, walking velocity, foot angle, anteroposterior margin of stability, percentage double support, step length, and step width were compared between iSCI, AB-self selected, and AB-slow walking groups. Associations between slip intensity, indicated by peak post-slip heel velocity, and stability measures were also examined through correlation analysis. Individuals with iSCI walked slower, took shorter steps, and spent a greater percentage of time in double support compared with AB individuals walking at a self-selected pace (P < .01). Slower walking velocity was correlated with slower post-slip velocity in participants with iSCI (P = .01) only. Individuals with iSCI walk with greater stability than AB individuals during unperturbed walking because of a lower self-selected speed, which appears to reduce the intensity of an unexpected slip perturbation. III.

Sections du résumé

BACKGROUND
Ambulatory individuals with incomplete spinal cord injury (iSCI) experience frequent falls suggesting impairments in their balance control. Individuals with iSCI are more stable during normal walking as compared to able-bodied (AB) individuals; however, it is not known whether this increased stability helps prevent hazardous slips.
OBJECTIVE
To compare walking stability during normal walking between iSCI and AB individuals, and to study the association between stability during normal walking and the intensity of an unexpected slip perturbation.
DESIGN
Cross-sectional.
SETTING
Biomechanics of Balance and Movement lab, University of Saskatchewan, Saskatoon.
PARTICIPANTS
Twenty iSCI (15 men; age: M = 60.05, SD = 17.77 years) and 16 (12 men; age: M = 58.92, SD = 17.10 years) AB individuals.
METHODS
Stability measures during unperturbed walking at a self-selected speed were collected from all the participants. Additionally, stability measures were also collected from 10 of the AB participants walking at a slower speed. An unexpected slip perturbation was recorded in all participants during a self-selected speed trial and peak-slip heel velocity post slip was recorded.
MAIN OUTCOME MEASUREMENTS
Measures of stability: ankle co-contraction, required coefficient of friction, walking velocity, foot angle, anteroposterior margin of stability, percentage double support, step length, and step width were compared between iSCI, AB-self selected, and AB-slow walking groups. Associations between slip intensity, indicated by peak post-slip heel velocity, and stability measures were also examined through correlation analysis.
RESULTS
Individuals with iSCI walked slower, took shorter steps, and spent a greater percentage of time in double support compared with AB individuals walking at a self-selected pace (P < .01). Slower walking velocity was correlated with slower post-slip velocity in participants with iSCI (P = .01) only.
CONCLUSIONS
Individuals with iSCI walk with greater stability than AB individuals during unperturbed walking because of a lower self-selected speed, which appears to reduce the intensity of an unexpected slip perturbation.
LEVEL OF EVIDENCE
III.

Identifiants

pubmed: 30036682
pii: S1934-1482(18)30390-3
doi: 10.1016/j.pmrj.2018.07.012
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

270-277

Informations de copyright

© 2018 American Academy of Physical Medicine and Rehabilitation.

Auteurs

Tarun Arora (T)

College of Medicine, University of Saskatchewan, Saskatoon, Canada.
School of Rehabilitation Science, University of Saskatchewan, Saskatoon, Canada.

Kristin E Musselman (KE)

College of Medicine, University of Saskatchewan, Saskatoon, Canada.
School of Rehabilitation Science, University of Saskatchewan, Saskatoon, Canada.
Toronto Rehabilitation Institute-University Health Network, Toronto, Canada.
Department of Physical Therapy, Faculty of Medicine, University of Toronto, Canada.

Joel L Lanovaz (JL)

College of Kinesiology, University of Saskatchewan, Saskatchewan, Canada.

Gary Linassi (G)

College of Medicine, University of Saskatchewan, Saskatoon, Canada.
School of Rehabilitation Science, University of Saskatchewan, Saskatoon, Canada.

Catherine Arnold (C)

College of Medicine, University of Saskatchewan, Saskatoon, Canada; School of Rehabilitation Science, University of Saskatchewan, Saskatoon, Canada.

Stephan Milosavljevic (S)

College of Medicine, University of Saskatchewan, Saskatoon, Canada.
School of Rehabilitation Science, University of Saskatchewan, Saskatoon, Canada.

Alison Oates (A)

College of Kinesiology, University of Saskatchewan, SK, Canada.

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