Reactive balance responses to an unexpected slip perturbation in individuals with incomplete spinal cord injury.
Arm and heel trajectory
EMG onset
Margin of stability
Reactive balance control
Slip perturbation
Spinal cord injury
Journal
Clinical biomechanics (Bristol, Avon)
ISSN: 1879-1271
Titre abrégé: Clin Biomech (Bristol, Avon)
Pays: England
ID NLM: 8611877
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
05
01
2019
revised:
05
05
2020
accepted:
26
06
2020
pubmed:
13
7
2020
medline:
23
4
2021
entrez:
13
7
2020
Statut:
ppublish
Résumé
Frequent falls while walking among individuals with incomplete spinal cord injury may suggest impairments in reactive balance control; however, reactive balance control during walking has not been studied in this population. The objective was to compare reactive balance control with respect to changes in margin of stability, onset of arm and heel responses, and onset and magnitude of muscle activity following an unexpected slip perturbation in individuals with incomplete spinal cord injury and able-bodied individuals. Kinematic and electromyography data were obtained during normal walking and one unexpected slip. Changes in margin of stability following a compensatory or aborted step, onset of arms and trail heel responses, and onset and magnitude of activation of the tibialis anterior, soleus and gluteus medius were calculated. Multivariate analyses compared responses between incomplete spinal cord injury and able-bodied groups. Data from 16 participants with incomplete spinal cord injury (all American Spinal Injury Association Impairment Scale Grade D, 8 with tetraplegia) and 13 age-and-sex matched able-bodied individuals were included. Individuals with incomplete spinal cord injury demonstrated limited ability to increase margin of stability in the lateral direction during a compensatory or aborted step, and a smaller magnitude of soleus activity compared to able-bodied individuals. There are limitations in reactive balance control of individuals with incomplete spinal cord injury, which may be a reason for the high frequency of falls in this population. Reactive balance assessment should be included as a component of routine balance assessment and fall avoidance strategies in this population.
Sections du résumé
BACKGROUND
Frequent falls while walking among individuals with incomplete spinal cord injury may suggest impairments in reactive balance control; however, reactive balance control during walking has not been studied in this population. The objective was to compare reactive balance control with respect to changes in margin of stability, onset of arm and heel responses, and onset and magnitude of muscle activity following an unexpected slip perturbation in individuals with incomplete spinal cord injury and able-bodied individuals.
METHODS
Kinematic and electromyography data were obtained during normal walking and one unexpected slip. Changes in margin of stability following a compensatory or aborted step, onset of arms and trail heel responses, and onset and magnitude of activation of the tibialis anterior, soleus and gluteus medius were calculated. Multivariate analyses compared responses between incomplete spinal cord injury and able-bodied groups.
FINDINGS
Data from 16 participants with incomplete spinal cord injury (all American Spinal Injury Association Impairment Scale Grade D, 8 with tetraplegia) and 13 age-and-sex matched able-bodied individuals were included. Individuals with incomplete spinal cord injury demonstrated limited ability to increase margin of stability in the lateral direction during a compensatory or aborted step, and a smaller magnitude of soleus activity compared to able-bodied individuals.
INTERPRETATION
There are limitations in reactive balance control of individuals with incomplete spinal cord injury, which may be a reason for the high frequency of falls in this population. Reactive balance assessment should be included as a component of routine balance assessment and fall avoidance strategies in this population.
Identifiants
pubmed: 32653743
pii: S0268-0033(20)30217-5
doi: 10.1016/j.clinbiomech.2020.105099
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
105099Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest None.