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Meta-Analysis
. 2025 Jul 1;15(1):22276.
doi: 10.1038/s41598-025-06765-5.

Trunk kinematics during seated functional activities in individuals with spinal cord injury: a systematic review and meta-analysis

Maria Del Rocio Hidalgo Mas #  1 , Ruo-Yan Wu #  1   2 , Tom Nightingale  1   3 , Eduardo Martinez Valdes  1 , Zubair Ahmed  3   4   5 , Shin-Yi Chiou  6   7
Affiliations
Meta-Analysis

Trunk kinematics during seated functional activities in individuals with spinal cord injury: a systematic review and meta-analysis

Maria Del Rocio Hidalgo Mas et al. Sci Rep. .

Abstract

This systematic review with meta-analysis compared the differences in trunk kinematics between persons living with spinal cord injury (PwSCI) and non-SCI individuals during sitting-based daily activities. A systematic search was conducted in MEDLINE, EMBASE, CINAHL-PLUS and Web of Science databases to identify relevant studies from inception up until 22nd March 2024. A total of 36 studies with 444 participants (mean age 38.9 ± 8.4 years; 361 males) were included, of whom 272 had AIS A/B classification, with injury levels ranging from C4 to L2. Three main tasks were identified: reaching, transfers, and wheeling. Four studies reported data on trunk displacement and a meta-analysis indicated that healthy controls showed significantly greater trunk displacement than SCI participants in forward-reaching tests (SMD = 2.07; 95% CI = 0.42-3.72; P = 0.01). Forward flexion and trunk rotation might be useful strategies to compensate for muscle weakness during transfers and wheelchair propulsion. SCI participants showed reduced trunk displacement during reaching compared to controls, indicating impaired trunk control and sitting balance. Transfer and wheeling trunk strategies vary based on muscle function. Further research on trunk kinematics is needed to guide rehabilitation tailored to individual abilities.

Keywords: Paraplegia; Reaching; Tetraplegia; Transfer; Wheeling.

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Conflict of interest statement

Declarations. Ethical approval: Ethical review was not required for this project as it is a systematic review of published literature and does not contain patient information. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram.
Fig. 2
Fig. 2
Risk of bias summary in the included studies. Risk of bias in (A) cross-sectional studies, (B) quasi-experimental studies and (C) case-series.
Fig. 3
Fig. 3
Forest plot to compare comparison of trunk displacement in the forward-reaching test between participants living with spinal cord injury and non-injured controls.
Fig. 4
Fig. 4
Trunk strategies during transfers. (A) Lateral transfer. (adapted from Allison 1993). (B) Pivot transfer (based on Desroches 2013b, Perry 1996, Gagnon 2008).
See this image and copyright information in PMC

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