Spinal Cord Injury and Seated Postural Control: A Test of the Rambling and Trembling Hypothesis

Rambling-trembling analysis separates the center of pressure into two components: the rambling component (RM: supraspinal) and trembling component (TM: muscle stiffness/reflex). We hypothesized that persons with spinal cord injury (SCI) would demonstrate decreased RM resulting from altered supraspinal processing and increased TM resulting from increased muscle stiffness. We also anticipated that the TM component would be greater in SCI patients with Harrington rods than in those without them. The seated postural control was assessed in 18 persons with SCI, comprising 12 with and six without Harrington rods, and 18 age-matched controls. The SCI group had greater center of pressure sway, RM, and TM components than the controls, with no difference in the postural sway between the SCI subgroups, suggesting that the impairment of seated postural control in individuals with SCI results from disturbed supraspinal and peripheral mechanisms, but that the control itself is unaffected by internal fixation with Harrington rods. These were not entirely consistent with our hypothesis.