Katherine Chan1, Jae Woung Lee1,2, Janelle Unger1,3, Jaeeun Yoo1,2, Kei Masani1,2, Kristin E Musselman4,5,6. 1. KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada. 2. Institute of Biomaterials & Biomedical Engineering, University of Toronto, Toronto, ON, Canada. 3. Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada. 4. KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada. kristin.musselman@uhn.ca. 5. Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada. kristin.musselman@uhn.ca. 6. Department of Physical Therapy, University of Toronto, Toronto, ON, Canada. kristin.musselman@uhn.ca.
Abstract
STUDY DESIGN: Cross sectional. OBJECTIVES: To compare the reactive stepping ability of individuals living with incomplete spinal cord injury or disease (SCI/D) to that of sex- and age-matched able-bodied adults. SETTING: A tertiary SCI/D rehabilitation center in Canada. METHODS: Thirty-three individuals (20 with incomplete SCI/D) participated. Participants assumed a forward lean position in standing whilst 8-12% of their body weight was supported by a horizontal cable at waist height affixed to a rigid structure. The cable was released unexpectedly, simulating a forward fall and eliciting one or more reactive steps. Behavioral responses (i.e., single step versus non-single step) were compared using a Chi-square test. The following temporal parameters of reactive stepping were compared using t-tests: the onset of muscle activation in 12 lower extremity muscles (six per limb) and step-off, step contact and swing time of the stepping leg. RESULTS: Behavioral responses were significantly different between groups (χ2 = 13.9 and p < 0.01) with participants with incomplete SCI/D showing more non-single step responses (i.e., multi-steps and falls). The onsets of muscle activation were more variable in participants with incomplete SCI/D, but only the stepping tibialis anterior showed a significantly slower onset in this group compared with able-bodied adults (t = -2.11 and p = 0.049). Movement timing of the stepping leg (i.e., step-off, step contact, and swing time) was not significantly different between groups. CONCLUSIONS: Reactive stepping ability of individuals with incomplete SCI/D is impaired; however, this impairment is not explained by temporal parameters. The findings suggest that reactive stepping should be targeted in the rehabilitation of ambulatory individuals with SCI/D.
STUDY DESIGN: Cross sectional. OBJECTIVES: To compare the reactive stepping ability of individuals living with incomplete spinal cord injury or disease (SCI/D) to that of sex- and age-matched able-bodied adults. SETTING: A tertiary SCI/D rehabilitation center in Canada. METHODS: Thirty-three individuals (20 with incomplete SCI/D) participated. Participants assumed a forward lean position in standing whilst 8-12% of their body weight was supported by a horizontal cable at waist height affixed to a rigid structure. The cable was released unexpectedly, simulating a forward fall and eliciting one or more reactive steps. Behavioral responses (i.e., single step versus non-single step) were compared using a Chi-square test. The following temporal parameters of reactive stepping were compared using t-tests: the onset of muscle activation in 12 lower extremity muscles (six per limb) and step-off, step contact and swing time of the stepping leg. RESULTS: Behavioral responses were significantly different between groups (χ2 = 13.9 and p < 0.01) with participants with incomplete SCI/D showing more non-single step responses (i.e., multi-steps and falls). The onsets of muscle activation were more variable in participants with incomplete SCI/D, but only the stepping tibialis anterior showed a significantly slower onset in this group compared with able-bodied adults (t = -2.11 and p = 0.049). Movement timing of the stepping leg (i.e., step-off, step contact, and swing time) was not significantly different between groups. CONCLUSIONS: Reactive stepping ability of individuals with incomplete SCI/D is impaired; however, this impairment is not explained by temporal parameters. The findings suggest that reactive stepping should be targeted in the rehabilitation of ambulatory individuals with SCI/D.
Authors: Elizabeth L Inness; Avril Mansfield; Louis Biasin; Karen Brunton; Mark Bayley; William E McIlroy Journal: Gait Posture Date: 2014-12-10 Impact factor: 2.840
Authors: Janelle Unger; Katherine Chan; Jae W Lee; B Catharine Craven; Avril Mansfield; Mohammad Alavinia; Kei Masani; Kristin E Musselman Journal: Front Neurol Date: 2021-02-02 Impact factor: 4.003