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Walking Stability During Normal Walking and Its Association with Slip Intensity Among Individuals with Incomplete

Tarun Arora^1,2, Kristin E Musselman^1,2,3,4, Joel L Lanovaz⁵

¹College of Medicine, University of Saskatchewan, Saskatoon, Canada.

PM & R : the Journal of Injury, Function, and Rehabilitation

|July 24, 2018

Abstract

Background:

Ambulatory individuals with incomplete spinal cord injury (iSCI) experience frequent falls suggesting impairments in their balance control. Individuals with iSCI are more stable during normal walking as compared to able-bodied (AB) individuals; however, it is not known whether this increased stability helps prevent hazardous slips.

Objective:

To compare walking stability during normal walking between iSCI and AB individuals, and to study the association between stability during normal walking and the intensity of an unexpected slip perturbation.

Design:

Cross-sectional.

Setting:

Biomechanics of Balance and Movement lab, University of Saskatchewan, Saskatoon.

Participants:

Twenty iSCI (15 men; age: M = 60.05, SD = 17.77 years) and 16 (12 men; age: M = 58.92, SD = 17.10 years) AB individuals.

Methods:

Stability measures during unperturbed walking at a self-selected speed were collected from all the participants. Additionally, stability measures were also collected from 10 of the AB participants walking at a slower speed. An unexpected slip perturbation was recorded in all participants during a self-selected speed trial and peak-slip heel velocity post slip was recorded.

Main Outcome Measurements:

Measures of stability: ankle co-contraction, required coefficient of friction, walking velocity, foot angle, anteroposterior margin of stability, percentage double support, step length, and step width were compared between iSCI, AB-self selected, and AB-slow walking groups. Associations between slip intensity, indicated by peak post-slip heel velocity, and stability measures were also examined through correlation analysis.

Results:

Individuals with iSCI walked slower, took shorter steps, and spent a greater percentage of time in double support compared with AB individuals walking at a self-selected pace (P < .01). Slower walking velocity was correlated with slower post-slip velocity in participants with iSCI (P = .01) only.

Conclusions:

Individuals with iSCI walk with greater stability than AB individuals during unperturbed walking because of a lower self-selected speed, which appears to reduce the intensity of an unexpected slip perturbation.

Level Of Evidence:

III.

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