Investigating proactive balance control in individuals with incomplete spinal cord injury while walking on a known slippery surface

Bone, Mackenzie D.; Arora, Tarun; Musselman, Kristin E.; Lanovaz, Joel L.; Linassi, Gary; Oates, Alison

doi:10.1016/j.neulet.2021.135744

Cited by 8 publications

(13 citation statements)

References 110 publications

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“…The increase in the AP MoS, favouring a resistance to a forward loss of stability, when walking in the W2 condition (Figure 2B) contradicts the findings of a previous study that exposed subjects to known slippery conditions 16 . One key difference between the previous study and the current study is that in the previous study the subjects were subjected to identical slip conditions repetitively, whereas in our study the friction of the ground surface was likely different from stride to stride.…”

Section: Discussioncontrasting

confidence: 53%

“…However, a larger distance from the anterior border of the BoS to the XCoM (more negative MoS) does not necessarily mean that the gait is less stable. Rather this suggests there is a smaller risk of a backwards loss of stability 3,16 . A XCoM that has exceeded the anterior border of the BoS by too great of a distance may result in a forward loss of balance.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, Curtze et al 14 found that the mean step width increased and mean ML MoS remained the same when walking on an irregular surface. Bone et al 16 investigated the effect of walking on a known slippery surface on balance control. When the subjects expected to slip, they reduced their stride length and increased the distance from the extrapolated CoM (XCoM) 3 to the posterior edge of the BoS, increasing the resistance to a backwards loss of stability.…”

Section: Introductionmentioning

confidence: 99%

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Stability in the Outdoors: Winter conditions elicit modified stepping behaviour but no additional compensation from the ankle or trunk strategies

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2022

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Healthy humans are proficient at maintaining stability when faced with diverse walking conditions, however, the control strategies that lead to this proficiency are unclear. Previous laboratory-based research has predominantly concluded that corrective stepping is the main strategy, but whether this finding holds when facing everyday obstacles outside of the laboratory is uncertain. We investigated changes in gait stability behaviour when walking outdoors in the summer and winter, hypothesizing that as ground conditions worsened in the winter, the stepping strategy would be hindered. Stability would then be maintained through compensatory strategies such as with ankle torques and trunk rotation. Data was collected in the summer and winter using inertial sensors to collect kinematics and instrumented insoles to collect vertical ground reaction forces. Using the goodness of fit for a multivariate regression between the centre of mass state and foot placement we found that, counter to our hypothesis, stepping was not hindered by winter conditions. Instead, the stepping strategy was modified to increase the anterior-posterior margin of stability, increasing the resistance to a forward loss of stability. With stepping being unhindered, we did not observe any additional compensation from the ankle or trunk strategies.

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Section: Discussioncontrasting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Stability in the Outdoors: Winter conditions elicit modified stepping behaviour but no additional compensation from the ankle or trunk strategies

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2022

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“…Additionally, during walking, dynamic stability may be impaired after SCI as evidenced by increased gait variability . Finally, although anticipatory postural control is likely to be minimally affected in people with less severe SCI (Bone et al, 2021;Thigpen et al, 2009), reactive postural control has been shown to be significantly impaired as people with SCI are more likely to require multiple steps to maintain balance after a forward fall and have a decreased ability to increase margin of stability (i.e. the distance between margins of one's BoS and their extrapolated CoM) after a slip .…”

Section: Postural Control In Scimentioning

confidence: 99%

Spatial Characteristics Of Reactive Stepping Among People Living With Chronic Incomplete Spinal Cord Injury

Heffernan

Lee²,

Chan³

et al. 2020

Archives of Physical Medicine and Rehabilitation

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“…This includes difficulty arresting lateral motion after a walking maneuver [4,5], impaired mediolateral foot placement [6], limited ability to increase lateral margins of stability following a perturbation [7], and sizeable metabolic energy cost to stabilize lateral motion during walking [8]. Many of the cautious gait patterns observed in people with iSCI (e.g., slower walking speeds, wider steps, shorter steps, more time in double support [6,[9][10][11][12]) have been suggested to be compensatory mechanisms that proactively aid in COM control during walking [9,10,12].…”

Section: Introductionmentioning

confidence: 99%

Control of Center of Mass Motion during Walking Predicts Gait and Balance in People with Incomplete Spinal Cord Injury

Dusane

Shafer

Ochs

et al. 2023

Preprint

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BackgroundThere is evidence that ambulatory people with incomplete spinal cord injury (iSCI) have an impaired ability to control lateral motion of their whole-body center of mass (COM) during walking. This impairment is believed to contribute to functional deficits in gait and balance, however that relationship is unclear. Thus, this cross-sectional study examines the relationship between the ability to control lateral COM motion during walking and functional measures of gait and balance in people with iSCI.MethodsWe assessed the ability to control lateral COM motion during walking and conducted clinical gait and balance outcome measures on twenty ambulatory adults with chronic iSCI (C1-T10 injury, American Spinal Injury Association Impairment Scale C or D). To assess their ability to control lateral COM motion, participants performed three treadmill walking trials. During each trial, real-time lateral COM position and a target lane were projected on the treadmill. Participants were instructed to keep their lateral COM position within the lane. If successful, an automated control algorithm progressively reduced the lane width, making the task more challenging. If unsuccessful, the lane width increased. The adaptive lane width was designed to challenge each participant’s maximum capacity to control lateral COM motion during walking. To quantify control of lateral COM motion, we calculated lateral COM excursion during each gait cycle and then identified the minimum lateral COM excursion occurring during five consecutive gait cycles. Our clinical outcome measures were Berg Balance Scale (BBS), Timed Up and Go test (TUG), 10-Meter Walk Test (10MWT) and Functional Gait Assessment (FGA). We used a Spearman correlation analysis (ρ) to examine the relationship between minimum lateral COM excursion and clinical measures.ResultsMinimum lateral COM excursion had significant moderate correlations with BBS (ρ=−0.54, p=0.014), TUG (ρ=0.59, p=0.007), 10MWT-preferred (ρ=−0.59, p=0.006), and FGA (ρ=−0.59, p=0.007) and a significant strong correlation with 10MWT-fast (ρ=−0.68, p=0.001).ConclusionControl of lateral COM motion during walking predicts a wide range of clinical gait and balance measures in people with iSCI. This finding suggests the ability to control lateral COM motion during walking could be a contributing factor to gait and balance in people with iSCI.

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Investigating proactive balance control in individuals with incomplete spinal cord injury while walking on a known slippery surface

Cited by 8 publications

References 110 publications

Stability in the Outdoors: Winter conditions elicit modified stepping behaviour but no additional compensation from the ankle or trunk strategies

Stability in the Outdoors: Winter conditions elicit modified stepping behaviour but no additional compensation from the ankle or trunk strategies

Spatial Characteristics Of Reactive Stepping Among People Living With Chronic Incomplete Spinal Cord Injury

Control of Center of Mass Motion during Walking Predicts Gait and Balance in People with Incomplete Spinal Cord Injury

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