Reactive balance responses to an unexpected slip perturbation in individuals with incomplete spinal cord injury

被引:9
作者
Arora, Tarun [1 ,2 ,3 ]
Musselman, Kristin E. [2 ,3 ,4 ,5 ]
Lanovaz, Joel L. [6 ]
Linassi, Gary [2 ]
Arnold, Catherine [2 ,3 ]
Milosavljevic, Stephan [2 ,3 ]
Oates, Alison [6 ]
机构
[1] Cleveland Clin Fdn, Lerner Res Inst, 9500 Euclid Ave, Cleveland, OH 44195 USA
[2] Univ Saskatchewan, Coll Med, Saskatoon, SK, Canada
[3] Univ Saskatchewan, Sch Rehabil Sci, Saskatoon, SK, Canada
[4] Univ Hlth Network, Toronto Rehabil Inst, Toronto, ON, Canada
[5] Univ Toronto, Fac Med, Dept Phys Therapy, Toronto, ON, Canada
[6] Univ Saskatchewan, Coll Kinesiol, Saskatoon, SK, Canada
关键词
Spinal cord injury; Slip perturbation; Reactive balance control; EMG onset; Margin of stability; Arm and heel trajectory; POSTURAL RESPONSES; MUSCLE ACTIVATION; DYNAMIC STABILITY; RECOVERY; WALKING; FALLS; STRATEGIES; SEVERITY; MALES; LEG;
D O I
10.1016/j.clinbiomech.2020.105099
中图分类号
R318 [生物医学工程];
学科分类号
0831 ;
摘要
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.
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页数:7
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