DOI: 10.20935/acadbiomedeng8439 ISSN:

Intralimb coordination and propulsion predict dynamic stability after incomplete spinal cord injury

Charles J. Creech, Oliver J. Daliet, Anastasia Zarkou, Edelle C. Field-Fote
Show PDF Cite
Introduction: Among people with motor incomplete spinal cord injury who are ambulatory, most falls occur during walking. Maintaining balance during walking requires control of the body’s center of mass (CoM). As control of the CoM is influenced by kinematics of the lower extremities, altered motor control in people with motor incomplete spinal cord injury can lead to instability during walking.

Materials and methods: We assessed the relationship between dynamic stability and lower extremity kinematics (i.e., gait quality) during walking in people with motor incomplete spinal cord injury using wearable triaxial accelerometers. Additionally, we explored the extent to which clinical measures of strength and spasticity predict gait quality. Dynamic stability was quantified as root mean square of CoM acceleration multiplied by leg length and normalized by the square of walking speed. Gait quality was quantified as intralimb coordination, propulsion, and step-length symmetry.

Results: All gait quality metrics were significantly correlated with normalized CoM acceleration in each plane of motion. Using regression analysis, intralimb coordination and propulsion were identified as significant predictors of normalized CoM acceleration in each plane. Intralimb coordination was explained by measures of strength and spasticity, while step-length symmetry was explained by strength only. Propulsion was not explained by measures of strength or spasticity.

Conclusions: Lower extremity kinematics were significant contributors to dynamic stability and can be partially explained by clinical measures of strength and spasticity. The findings of this analysis may aid clinicians in developing plans of care when attempting to improve dynamic stability during walking.

More from our Archive