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.

中文翻译：

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脊髓不完全损伤的个体对意外滑倒摄动的反应性平衡反应。

背景

在脊髓不完全损伤的个体中行走时经常摔倒可能表明反应平衡控制受到损害。但是，尚未对该人群研究步行过程中的反应性平衡控制。目的是比较在不完全脊髓损伤的个体和身体健全的个体发生意外滑倒扰动之后，在稳定性裕度，手臂和足跟反应发作以及肌肉活动的发作和大小方面的反应性平衡控制。

方法

运动和肌电图数据是在正常行走和一次意外滑脱过程中获得的。计算了代偿性或中止性步骤后的稳定性，手臂起步和后跟反应的稳定性以及胫骨前，比目鱼肌和臀小肌的激活程度和激活程度。多变量分析比较了不完全脊髓损伤和健全组之间的反应。

发现

包括来自16位脊髓损伤不完全的参与者（所有美国脊髓损伤协会损伤等级D级，四位瘫痪的8位参与者）和13位年龄和性别相匹配的强壮个体的数据。与健壮的个体相比，脊髓不完全损伤的个体表现出在代偿性或中止步骤中增加横向稳定性裕度的能力有限，并且比目鱼肌活动的幅度较小。

解释

脊髓损伤不完全的个体的反应平衡控制存在局限性，这可能是该人群高跌倒频率的原因。反应性平衡评估应作为该人群常规平衡评估和避免摔倒策略的组成部分。