Trunk control impairment is responsible for postural instability during quiet sitting in individuals with cervical spinal cord injury

Abstract Background Individuals with cervical spinal cord injury usually sustain impairments to the trunk and upper and lower limbs, resulting in compromised sitting balance. The objectives of this study were to: 1) compare postural control of individuals with cervical spinal cord injury and able-bodied individuals; and 2) investigate the effects of foot support and trunk fluctuations on postural control during sitting balance. Methods Ten able-bodied individuals and six individuals with cervical spinal cord injury were asked to sit quietly during two 60 s trials. The forces exerted on the seat and the foot support surfaces were measured separately using two force plates. The global centre of pressure sway was obtained from the measurements on the two force plates, and the sway for each force plate was calculated individually. Findings Individuals with spinal cord injury had at least twice as large global and seat sways compared to able-bodied individuals, while foot support sway was not significantly different between the two groups. Comparison between global and seat sways showed that anterior–posterior velocity of global sway was larger compared to the seat sway in both groups. Interpretation Postural control of individuals with cervical spinal cord injury was worse than that of able-bodied individuals. The trunk swayed more in individuals with spinal cord injury, while the stabilization effect of the feet did not differ between the groups. Foot support affected anterior–posterior fluctuations in both groups equally. Thus, trunk control is the dominant mechanism contributing to sitting balance in both able-bodied and spinal cord injury individuals.