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.

中文翻译：

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患有不完全脊髓损伤或疾病的人前倾后的反应性踏步。

研究设计横截面。目的比较患有不完全脊髓损伤或疾病（SCI / D）的个体与性别和年龄相匹配的健全成年人的反应性步进能力。在加拿大设立一个第三级SCI / D康复中心。方法33例患者（其中20例SCI / D不完整）参加了研究。参与者在站立时采取前倾姿势，而其体重的8-12％由固定在刚性结构上的腰部高​​度的水平电缆支撑。电缆意外释放，模拟向前跌落并引发一个或多个反应步骤。使用卡方检验比较行为反应（即，单步与非单步）。使用t检验比较了以下反应性步进的时间参数：下肢12块肌肉（每肢6个）的肌肉激活以及踩踏腿的下垂，步接触和挥杆时间的开始。结果组之间的行为反应显着不同（χ2= 13.9，p <0.01），SCI / D不完全的参与者表现出更多的非单步反应（即多步和跌倒）。与不健全的成年人相比，不完全SCI / D的参与者肌肉激活的发作更具可变性，但只有步进胫骨前部才显示出显着更慢的发作（t = -2.11和p = 0.049）。两组之间的踏脚运动时间（即，下脚，脚步接触和挥杆时间）没有显着差异。结论SCI / D不完全的个体的反应性步伐能力受到损害。然而，这种损害不能由时间参数来解释。研究结果表明，反应性踏步应针对SCI / D卧床患者的康复。