@article{ref1,
title="Reactive stepping after a forward fall in people living with incomplete spinal cord injury or disease",
journal="Spinal Cord",
year="2019",
author="Chan, Katherine and Lee, Jae Woung and Unger, Janelle and Yoo, Jaeeun and Masani, Kei and Musselman, Kristin E.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="STUDY DESIGN: Cross sectional. <br><br>OBJECTIVES: To compare the reactive stepping ability of individuals living with incomplete spinal cord injury or disease (SCI/D) to that of sex- and age-matched able-bodied adults. SETTING: A tertiary SCI/D rehabilitation center in Canada. <br><br>METHODS: Thirty-three individuals (20 with incomplete SCI/D) participated. Participants assumed a forward lean position in standing whilst 8-12% of their body weight was supported by a horizontal cable at waist height affixed to a rigid structure. The cable was released unexpectedly, simulating a forward fall and eliciting one or more reactive steps. Behavioral responses (i.e., single step versus non-single step) were compared using a Chi-square test. The following temporal parameters of reactive stepping were compared using t-tests: the onset of muscle activation in 12 lower extremity muscles (six per limb) and step-off, step contact and swing time of the stepping leg. <br><br>RESULTS: Behavioral responses were significantly different between groups (χ<sup>2</sup> = 13.9 and p < 0.01) with participants with incomplete SCI/D showing more non-single step responses (i.e., multi-steps and falls). The onsets of muscle activation were more variable in participants with incomplete SCI/D, but only the stepping tibialis anterior showed a significantly slower onset in this group compared with able-bodied adults (t = -2.11 and p = 0.049). Movement timing of the stepping leg (i.e., step-off, step contact, and swing time) was not significantly different between groups. <br><br>CONCLUSIONS: Reactive stepping ability of individuals with incomplete SCI/D is impaired; however, this impairment is not explained by temporal parameters. The findings suggest that reactive stepping should be targeted in the rehabilitation of ambulatory individuals with SCI/D.<p /> <p>Language: en</p>",
language="en",
issn="1362-4393",
doi="10.1038/s41393-019-0332-y",
url="http://dx.doi.org/10.1038/s41393-019-0332-y"
}