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

Abstract

III.

Use of the margin of stability to quantify stability in pathologic gait – a qualitative systematic review

“… MoS ML had significantly greater variability in post-SCI participants compared to controls suggesting compensatory control mechanisms to avoid falls. ML: CoP ML: Lateral ML: Minimum value during double-limb support Arora, et al (2019) [ 13 ] Cumulative anthropometric segmental mass properties (12 segment) Not specified AP: Anterior foot boundary BoS - XcoM AP: Anterior AP: Heel strike MoS AP for participants with spinal cord injury was significantly smaller than controls walking at matched speeds (p < 0.01). MoS AP was not significantly different between SCI participants and controls walking at their self-selected speed.…”

“…Participants with Parkinson’s disease were included in three studies [ 11 , 36 , 37 ]. Participants with spinal cord injury [ 13 , 38 ] and Multiple Sclerosis [ 12 , 39 ] were included in two studies each. Participants with unilateral peripheral vestibular disorder [ 18 ], facioscapulohumeral muscular dystrophy [ 40 ], Hereditary Spastic Paraparesis [ 41 ], spinal deformity [ 42 ], diabetes mellitus [ 43 ] and cerebellar lesions [ 44 ] were included in one study each.…”

“…The position of the CoM was estimated using the cumulative mass and position of each anthropometric segment in 18 studies [ 3 , 11 , 13 , 18 , 24 – 26 , 29 , 30 , 32 , 35 – 38 , 40 – 43 ], the geometric centre of a polygon created by four pelvic markers in six studies [ 14 , 23 , 28 , 31 , 39 , 45 ], using a fusion of low-pass filtered CoP data with high-pass filtered double-integrated CoM acceleration data in three studies [ 19 , 20 , 34 ], the geometric centre of a triangle created by the left and right anterior superior iliac spine, the mid-point between the left and right posterior superior iliac spine in one study [ 12 ] and the position of a cluster of markers on the pelvis in one study [ 44 ]. The methodology for CoM position estimation was unspecified in two studies [ 27 , 33 ].…”

“…Eighteen studies measured MoS AP . To calculate this, the BoS AP was defined by the toe marker or anterior boundary of the leading foot in seven studies [ 11 – 13 , 18 , 27 , 39 , 43 ], by the malleolar marker of the leading foot in 3 studies [ 14 , 28 , 31 ], by the heel marker in 3 studies [ 23 , 36 , 40 ], by the midpoint along the line between the front of each shoe in 2 studies [ 19 , 20 ] and by a metatarsal marker in 1 study [ 41 ]. The BoS AP was not explicitly defined in 2 studies [ 24 , 37 ].…”

Reactive stepping after a forward fall in people living with incomplete spinal cord injury or disease

“…The resulting sensorimotor deficits make everyday movements, such as standing and walking, difficult. In particular, it can be challenging for individuals with SCI/D to maintain their balance, defined here as maintaining the vertical projection of one's center of mass (i.e., the weighted average position of all parts of the body according to mass) within the base of support (i.e., the area of support beneath a person or object, including points of contact) [2,3], during standing and walking tasks [4][5][6]. Indeed, up to 75% of individuals with incomplete SCI/D fall at least once annually and most of these falls occur while walking [7][8][9].…”