Impaired foot placement strategy during walking in people with incomplete spinal cord injury

Journal of NeuroEngineering and Rehabilitation, 2022 · DOI: https://doi.org/10.1186/s12984-022-01117-0 · Published: November 23, 2022

Spinal Cord Injury Neurorehabilitation Biomechanics

Simple Explanation

This study investigates how people with incomplete spinal cord injury (iSCI) control their balance while walking, focusing on their foot placement strategy. The foot placement strategy is a key way we maintain balance from side to side when we walk. Researchers compared the foot placement of people with iSCI to that of healthy individuals. They looked at how accurately people placed their feet based on their body's position and movement. The study found that people with iSCI had more difficulty accurately placing their feet compared to healthy controls, regardless of how fast they were walking. This suggests that iSCI affects the ability to use foot placement to maintain balance.

Study Duration

Not specified

Participants

28 people with iSCI and 19 healthy controls

Evidence Level

Not specified

Key Findings

1
People with iSCI showed significantly higher foot placement deviation compared to healthy controls, independent of walking speed.
2
Participants with iSCI exhibited 0.40 cm (51%) and 0.33 cm (38%) higher foot placement deviation compared to healthy controls walking in the self-paced and the fixed-speed 50% condition, respectively.
3
Step width of people with iSCI was higher compared to healthy controls independent of walking speed.

Research Summary

The study aimed to determine if the ML foot placement strategy is impaired in people with iSCI compared to healthy controls, and investigated the relation between ML COM kinematics and ML foot placement during straight walking in both populations. The results showed that people with iSCI had higher foot placement deviation compared to healthy controls, indicating an impaired ML foot placement strategy, independent of walking speed. The study suggests that people with iSCI may compensate for this decreased foot placement strategy by increasing their step width, and future research should focus on improving the foot placement strategy by targeted balance training.

Practical Implications

Targeted Balance Training

Future research should focus on improving the foot placement strategy by targeted balance training to enhance walking stability in people with iSCI.

Compensatory Strategies

The study highlights that people with iSCI may compensate for a decreased foot placement strategy by increasing their step width, suggesting potential areas for intervention.

Understanding Mechanisms

Further research should focus on disentangling the role of proprioceptive information and decreased muscle coordination on the foot placement strategy to help design and optimize interventions for people with iSCI.

Study Limitations

1
Participants with iSCI were a mild to moderately affected group, so the results cannot be generalized to all individuals with iSCI.
2
Healthy controls were not sex- or age-matched to the participants with iSCI.
3
The study acknowledges that the healthy controls exhibited a lower SD of actual foot placement in the fixed-speed condition which could be the result of the treadmill mode.

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