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Observational Study
. 2014 Sep;37(5):537-47.
doi: 10.1179/2045772314Y.0000000246.

Trunk strength and function using the multidirectional reach distance in individuals with non-traumatic spinal cord injury

Sharon Gabison, Molly C Verrier, Sylvie Nadeau, Dany H Gagnon, Audrey Roy, Heather M Flett
Observational Study

Trunk strength and function using the multidirectional reach distance in individuals with non-traumatic spinal cord injury

Sharon Gabison et al. J Spinal Cord Med. 2014 Sep.

Abstract

Context: Trunk control is essential to engage in activities of daily living. Measuring trunk strength and function in persons with spinal cord injury (SCI) is difficult. Trunk function has not been studied in non-traumatic SCI (NTSCI).

Objectives: To characterize changes in trunk strength and seated functional reach in individuals with NTSCI during inpatient rehabilitation. To determine if trunk strength and seated reach differ between walkers and wheelchair users. To explore relationships between trunk and hip strength and seated functional reach.

Design: Observational study.

Setting: Two SCI rehabilitation facilities.

Participants: 32 subacute inpatients (mean age 48.0 ± 15.4 years).

Outcome measures: Isometric strength of trunk and hip and function (Multidirectional Reach Test: MDRT) were assessed at admission and within 2 weeks of discharge. Analysis of variance was conducted for admission measures (MDRT, hip and trunk strength) between walkers and wheelchair users. Changes in MDRT, hip and trunk strength were evaluated using parametric and non-parametric statistics. The level of association between changes in values of MRDT and strength was also examined.

Results: Significant differences between walkers and wheelchair users were found for strength measures (P < 0.05) but not for MDRT. Left- and right-sided reaches increased in wheelchair users only (P < 0.05). Associations between changes in hip strength, trunk strength, and reach distance were found (R = 0.67-0.73).

Conclusion: In clinical settings, it is feasible and relevant to assess trunk, hip strength, and MRDT. Future studies require strategies to increase the number of participants assessed, in order to inform clinicians about relevant rehabilitation interventions.

Keywords: Function; Muscle strength; Non-traumatic spinal cord injury; Rehabilitation; Trunk control.

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Figures

Figure 1
Figure 1
Representation of the MDRT. Using their preferred arm, subjects were asked to reach in one of the six different directions (forward, back, left, right, forward right, forward left) in random order, towards a target at the level of their acromion, with their opposite hand remaining on their thigh.
Figure 2
Figure 2
Mean trunk strength (Nm/kg) for all participants (n = 27) at admission and for matched pairs of walkers (n = 8) and wheelchair users (n = 9) at admission and discharge. Wheelchair users have lower trunk strength, particularly for extensors at both admission and discharge.
Figure 3
Figure 3
Mean sitting MDRT (% trunk length) for all participants (n = 22–25) at admission and for matched pairs of walkers (n = 7) and wheelchair users (n = 7–8) at admission and discharge. Wheelchair users gain further reach distances to the left and right than walkers.
Figure 4
Figure 4
Scatterplots showing significant (P = 0.01) association between changes in sitting MDRT (% trunk length) for matched pairs of walkers (blue diamonds) (n = 7) and wheelers (red squares) (n = 7) and hip or trunk strength changes.
See this image and copyright information in PMC

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