Gait variability following abrupt removal of external stabilization decreases with practice in incomplete spinal cord injury but increases in non-impaired individuals

Journal of NeuroEngineering and Rehabilitation, 2019 · DOI: https://doi.org/10.1186/s12984-018-0475-7 · Published: January 1, 2019

Spinal Cord Injury Neurology Biomechanics

Simple Explanation

The study investigated how people with and without incomplete spinal cord injuries (iSCI) adapt their walking when external support is suddenly removed. Researchers analyzed center of mass (COM) and step width variability, along with hip muscle activity, during these transitions. The findings suggest that individuals with iSCI prioritize improving their balance and stability, while non-impaired individuals focus on reducing effort.

Study Duration

Not specified

Participants

13 participants with iSCI and 12 non-impaired participants

Evidence Level

Not specified

Key Findings

1
Participants with iSCI showed decreased COM movement variability with practice, indicating improved motor control during transitions.
2
Non-impaired participants exhibited increased COM movement variability but decreased hip abductor muscle activity with practice.
3
Both groups significantly reduced movement variability in the presence of the stabilizing force field.

Research Summary

This study examined gait adaptation in individuals with and without incomplete spinal cord injury (iSCI) during abrupt transitions from a stabilized to an unassisted walking environment. The results indicated that individuals with iSCI prioritize control performance, reducing gait variability with practice, while non-impaired individuals prioritize control effort, decreasing muscle activity and increasing gait variability. These findings suggest that different populations may prioritize different aspects of performance when adapting to locomotor balance tasks.

Practical Implications

Rehabilitation Strategies

Rehabilitation programs for individuals with iSCI should focus on enhancing rapid motor adaptation to changing environments, especially concerning balance and stability.

Assistive Device Design

The design of assistive devices should consider the user's control priorities, whether that be improving stability or reducing effort.

Understanding Motor Learning

Further research should explore the cognitive and neural mechanisms underlying the different adaptation strategies observed in iSCI and non-impaired individuals.

Study Limitations

1
The method of using the transition length calculated from Transition 1 for all three transitions likely impacted the results.
2
Some participants were provided brief instances of physical support from experimenters for safety.
3
Individuals’ interpretation of this task and level of motivation may have affected their effort to control variability.

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