PTCase-ControlJournal of neuroengineering and rehabilitation2022

Impaired foot placement strategy during walking in people with incomplete spinal cord injury.

Eline Zwijgers, Edwin H F van Asseldonk, Marije Vos-van der Hulst and 2 others

PMID 36471441

WHAT IT FOUND

People with incomplete spinal cord injury placed their feet less accurately during walking than healthy controls, even when walking at the same slow speed.

They compensated by taking wider steps. This suggests balance training should specifically target foot placement accuracy.

Key findings

01Foot placement deviation was significantly higher in people with incomplete spinal cord injury compared to healthy controls, regardless of walking speed.

02Participants with incomplete spinal cord injury walked with significantly wider steps than healthy controls.

03Most participants in both groups still used the foot placement strategy, but it was less accurate in the injury group.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The study only included people with incomplete spinal cord injury who could walk without handrails, so results may not apply to those with more severe impairments. Healthy controls were not sex- or age-matched to the injury group, although no significant differences in age and sex were found between groups. The study could not determine whether impaired foot placement was caused by reduced sensation, reduced muscle control, or both.

Declared interests

The study was funded by the Nederlandse Organisatie voor Wetenschappelijk Onderzoek. The authors declared no competing interests.

The easy way to misread this

Do not assume that wider steps indicate poor balance. The study suggests wider steps may be a compensatory strategy to improve stability when foot placement accuracy is impaired. Training should aim to restore accurate foot placement rather than simply narrowing step width.

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