Reactive stepping after a forward fall in people living with incomplete spinal cord injury or disease.
Spinal Cord
; 58(2): 185-193, 2020 Feb.
Article
em En
| MEDLINE
| ID: mdl-31358908
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.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Tempo de Reação
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Doenças da Medula Espinal
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Acidentes por Quedas
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Equilíbrio Postural
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Posição Ortostática
Tipo de estudo:
Observational_studies
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Prevalence_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article