Seated reach distance and trunk excursion accurately reflect dynamic postural control in individuals with motor-incomplete spinal cord injury

• Type of Material: Article
• Authors: Edelle Field-Fote, Emory University; Saumitra Sinha Ray, University of Miami
• Language: English
• Date: 2010-10-01
• Publisher: NATURE PUBLISHING GROUP
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2010 International Spinal Cord Society All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1038/sc.2010.11
• Title of Journal or Parent Work: SPINAL CORD
• Volume: 48
• Issue: 10
• Start Page: 745
• End Page: 749
• Grant/Funding Information: We are grateful for support from NIH grant HD41487, the Craig H. Nielsen Foundation, and The Miami Project to Cure Paralysis. We thank Stephen Lindley for technical contributions.
• Keywords: Life Sciences & Biomedicine; COORDINATION; postural control; balance; VALIDITY; BALANCE; RELIABILITY; FUNCTIONAL REACH; functional reach; Rehabilitation; STROKE; PERFORMANCE; Clinical Neurology; Neurosciences & Neurology; limits of stability; Science & Technology; LOWER-LIMBS
• Research Categories: Biology, Neuroscience; Health Sciences, Medicine and Surgery

Abstract

Study design:To determine whether kinematic measures of reach excursion are valid measures of postural control in individuals with motor-incomplete spinal cord injury (MISCI), seated reach test (SRT; obtained from a wrist marker) values and associated trunk excursion values (obtained from a C7 marker) were compared with center of pressure excursion (COPE). Data were obtained from individuals with MISCI and from non-disabled individuals for each of four directions. To assess the reliability of these measures in subjects with MISCI, these values were collected on two separate days.Objective:Dynamic seated postural control is essential for individuals who perform their daily activities from a wheelchair. Although seated reach distance is used as a proxy measure for postural control, it is unknown whether this is an accurate and reliable measure of the limits of stability in individuals with MISCI.Results:In subjects with MISCI, the SRT was significantly correlated with the COPE in three directions of reaching (r≥0.71), with the exception being leftward reaching. Trunk excursion was correlated with COPE in all directions (r≥0.93). In non-disabled individuals, both SRT (r≥0.56) and trunk excursion (r≥0.91) were correlated with COPE for all directions. In individuals with MISCI, there was significant intersession agreement for both reach distance (intraclass correlation coefficient (ICC)≥0.78) and trunk excursion (ICC≥0.77) measured in all directions.Conclusions:Although both SRT and trunk excursion are reasonable reflections of COPE, measurement of postural control based on trunk excursion has advantages for individuals who may have difficulty maintaining arm position during reaching. Reach distance is highly reliable in individuals with MISCI in all directions of reaching.