Differential deficits in spatial and temporal interlimb coordination during walking in persons with incomplete spinal cord injury

Gait Posture, 2020 · DOI: 10.1016/j.gaitpost.2019.10.023 · Published: January 1, 2020

Spinal Cord Injury Neurology Biomechanics

Simple Explanation

This study investigates how incomplete spinal cord injury (iSCI) affects the coordination between legs during walking, focusing on both the timing and placement of steps. The research compares individuals with iSCI to able-bodied individuals to identify differences in spatial (step length) and temporal (step time) aspects of walking. The ultimate goal is to find specific targets for gait rehabilitation that can improve walking ability in people with iSCI by addressing deficits in interlimb coordination.

Study Duration

Not specified

Participants

16 persons with chronic iSCI and 11 able-bodied individuals

Evidence Level

Not specified

Key Findings

1
Participants with iSCI demonstrated greater spatial and temporal asymmetry, as well as, reduced gap and phase interlimb coordination as compared to age-matched controls.
2
Spatial asymmetry associated with decreased walking speed and increased reliance on hand-held assistive devices.
3
No linear relationships between spatial and temporal asymmetry indices

Research Summary

This study reports on impaired interlimb coordination during overground walking in persons with iSCI. Results from this study demonstrate that spatial and temporal interlimb coordination are impaired and appear dissociated after iSCI. Modification of step timing or step positioning between left and right legs may improve with gait training paradigms that use spatial and/or temporal feedback

Practical Implications

Targeted Gait Training

Gait training methods that target well-defined space and time domains of interlimb coordination may enhance overground gait training in persons with iSCI.

Assistive Device Use

Spatial asymmetry corresponds to increased reliance on walking aides after iSCI, suggesting interventions should focus on improving spatial symmetry to reduce dependence on these devices.

Precision Treatments

These findings affirm the need for precision treatments that recalibrate spatial and temporal control of interlimb movements and subsequently improve functional walking after iSCI.

Study Limitations

1
Small sample size restricted generalization of AD reliance on interlimb coordination.
2
Higher functioning cohort of AIS D participants did not enable us to examine the impact of more severe SCI on spatial and temporal interlimb coordination.
3
iSCI participants walked ~58% slower than AB controls.

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