Aquatic Therapy after Incomplete Spinal Cord Injury: Gait Initiation Analysis Using Inertial Sensors

Area of Science:

• Biomechanics
• Rehabilitation Medicine
• Neuroscience

Background:

• Gait initiation is crucial for mobility, especially in individuals with neurological impairments.
• Incomplete spinal cord injury (iSCI) often affects sensory and motor systems, impacting gait.
• Aquatic therapy shows promise for improving functional capacity in iSCI patients.

Purpose of the Study:

• To evaluate gait initiation in iSCI patients using wearable inertial sensors.
• To compare gait initiation parameters between dry-land and aquatic conditions.
• To understand the influence of water immersion on anticipatory postural adjustments in iSCI.

Main Methods:

• A protocol using four wearable inertial sensors was employed.
• Temporal and acceleration-based measures of anticipatory postural adjustments were computed.
• Ten iSCI patients participated, with data collected in both dry-land and aquatic environments.

Main Results:

• Water immersion led to a significant increase in first step duration (1.44 s vs. 0.70 s).
• Root mean squared accelerations for the upper and lower trunk were reduced in water (0.39 m/s² and 0.41 m/s² vs. 0.72 m/s² and 0.85 m/s²).
• These changes were observed in both medio-lateral and antero-posterior directions.

Conclusions:

• Gait initiation in iSCI patients is modulated by the aquatic environment.
• Altered trunk accelerations and prolonged step duration suggest different motor control strategies in water.
• Routine estimation of these parameters can inform therapeutic interventions for iSCI patients in various environments.