Spatial characteristics of reactive stepping among people living with chronic incomplete spinal cord injury

The Journal of Spinal Cord Medicine, 2023 · DOI: 10.1080/10790268.2023.2175575 · Published: January 1, 2023

Simple Explanation

This study compares how people with incomplete spinal cord injuries (iSCI) and able-bodied (AB) individuals adjust their steps to regain balance after a sudden forward lean. Researchers measured the length, width, and height of the first step taken during this balance recovery to see if there were differences between the two groups. The goal was to understand if problems in step size and consistency contribute to the balance issues and increased falls often experienced by individuals with iSCI.

Study Duration

Not specified

Participants

12 individuals with iSCI and 11 age- and sex-matched AB individuals

Evidence Level

Cross sectional

Key Findings

1
Individuals with iSCI showed similar step length, width, and height compared to AB individuals when reacting to a forward lean.
2
However, people with iSCI exhibited greater variability in the length and width of their reactive steps, meaning their steps were less consistent from one trial to the next.
3
The variability in step length and width was not correlated with fall history, lower extremity strength, or behavioral responses during the experiment among iSCI participants.

Research Summary

This study investigated the spatial characteristics of reactive stepping in individuals with iSCI compared to AB controls using the Lean-and-Release test. The key finding was that while the average step length, width, and height were similar between groups, individuals with iSCI showed significantly greater variability in step length and width. These findings suggest that inconsistency in step placement, rather than step size itself, may contribute to balance deficits in people with iSCI.

Practical Implications

Rehabilitation Protocol Development

Findings suggest focusing on reducing movement variability in balance training for iSCI, rather than solely targeting step length or height.

Balance Training Approaches

Consider incorporating repetitive practice and perturbation-based balance training to improve consistency in reactive stepping.

Clinical Trials

Future clinical trials should include measurement of spatial parameters of reactive stepping to better assess the effectiveness of balance interventions.

Study Limitations

1
Small sample size limits the statistical power and generalizability of the findings.
2
The study population had a smaller proportion of individuals with traumatic SCI and fewer males than females, which may not represent the broader SCI population.
3
Participants' awareness of the upcoming release in the Lean-and-Release test may have influenced their responses through anticipatory strategies.

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