Control of center of mass motion during walking correlates with gait and balance in people with incomplete spinal cord injury

Frontiers in Neurology, 2023 · DOI: 10.3389/fneur.2023.1146094 · Published: May 30, 2023

Spinal Cord Injury Rehabilitation Biomechanics

Simple Explanation

This study investigates the connection between controlling side-to-side body motion during walking and how well people with incomplete spinal cord injuries (iSCI) can walk and balance. Participants walked on a treadmill while trying to keep their body's center of mass within a moving lane, and their walking and balance were assessed using standard clinical tests. The study found that better control of side-to-side motion was linked to better walking and balance scores, suggesting it's an important factor for these abilities in people with iSCI.

Study Duration

Not specified

Participants

20 ambulatory adults with chronic iSCI (C1-T10 injury, American Spinal Injury Association Impairment Scale C or D)

Evidence Level

Cross-sectional study

Key Findings

1
Minimum lateral COM excursion had significant moderate correlations with BBS (ρ = −0.54, p = 0.014), TUG (ρ = 0.59, p = 0.007), FGA (ρ = −0.59, p = 0.007), 10MWT-preferred (ρ = −0.59, p = 0.006) and 10MWT-fast (ρ = −0.68, p = 0.001).
2
Smaller minimum lateral COM excursions were associated with shorter TUG times and higher scores on the FGA, both indicating greater walking ability.
3
Individuals with greater BBS scores, which indicate greater postural control and balance, demonstrated a better ability to control their lateral COM excursion during walking.

Research Summary

This study examined the relationship between control of lateral center of mass (COM) motion during walking and functional gait and balance measures in individuals with incomplete spinal cord injury (iSCI). The results indicated that better control of lateral COM motion during walking was moderately correlated with improved performance on clinical measures of walking balance, walking speed, and postural balance. The findings suggest that the ability to control lateral COM motion during walking could be a contributing factor to gait and balance outcomes in people with iSCI, highlighting a potential target for clinical interventions.

Practical Implications

Clinical Balance Assessment

The ability to control lateral COM motion during walking is closely related to functional measures of gait and balance, highlighting the importance of assessing this aspect in individuals with iSCI.

Targeted Clinical Interventions

Clinical interventions could focus on traditional balance training tasks, like narrow base of support walking, rapid maneuvers during walking, or manual perturbations to improve lateral balance control.

Novel Training Approaches

A novel approach to train lateral COM control in people with iSCI could be to perform gait training in a movement amplification field that applies proportional forces in the same direction as the real-time lateral velocity of the participant.

Study Limitations

1
The study's correlational design does not establish a causative relationship between lateral COM motion and gait/balance outcomes.
2
The relatively small sample size and inclusion of high-functioning, community-dwelling individuals with iSCI limit the generalizability of the findings.
3
The use of visual feedback during the treadmill task may have influenced participants' normal walking patterns.

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