Postural control strategy after incomplete spinal cord injury: effect of sensory inputs on trunk-leg movement coordination.
Alireza Noamani, Jean-François Lemay, Kristin E Musselman and 1 others
PMID 33109209WHAT IT FOUND
People with incomplete spinal cord injury struggle to shift from an ankle to a hip balance strategy when sway increases or surfaces soften.
Trunk-leg coherence measured by two sensors tracked this reliably, unlike standard balance measures.
Key findings
01At higher sway frequencies, individuals with incomplete spinal cord injury showed significantly larger trunk-leg coherence than able-bodied controls, indicating a reduced ability to shift from an ankle to a mixed ankle-hip strategy.
02Standing on foam significantly increased trunk-leg coherence at higher frequencies in able-bodied participants but not in those with incomplete spinal cord injury, suggesting the injured group already relies less on somatosensory input for balance.
03Trunk-leg coherence measures showed excellent test-retest reliability across all standing conditions, outperforming most conventional center-of-pressure and center-of-mass balance biomarkers.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only thirteen participants with incomplete spinal cord injury were studied, and all had relatively good motor recovery (lower extremity motor scores averaging 44.8 out of 50), so findings may not apply to those with more severe impairment. The model assumed bilateral symmetry and treated the shank and thigh as a single segment, ignoring knee contributions and any left-right differences. The study compared groups at a single time point; it did not test whether training could restore the missing hip strategy.
Declared interests
Funded by the Alberta Innovates Graduate Scholarship and the Craig H. Neilsen Foundation. No commercial conflicts of interest are reported.
The easy way to misread this
Do not read the foam-surface result as evidence that people with incomplete spinal cord injury are immune to sensory challenge. The lack of change in coherence on foam likely reflects an already-compromised somatosensory system, not a stable strategy. Standard balance scores that look unchanged may still hide a specific failure in hip-strategy recruitment.