Table 1.
Participants, interventions, comparison and outcome measures of all studies and quality score STROBE checklist
| Reference no. | Study | Participants | Intervention | Comparison | Outcome measure | Total score STROBE | Methodological quality |
|---|---|---|---|---|---|---|---|
| [49] | Bernard et al. | Six SCI T4-8 (high), six SCI T11-L5 (low) and six AB | Perturbation on moving platform for wheelchair | High SCI, low SCI, AB 4 oscillation levels | Damping factor of head | 4 | Moderate-poor |
| [29] | Boswell Ruys et al. | 30 SCI C5-L2 AIS-D, 14 high level and 16 low level | Upper body sway = sit still unsupported for 30 s Maximal balance range forwards and backwards Coordinated stability = follow track with pencil by adjusting trunk position in bending and rotating. |
New (<1 year post injury) vs. old (>1 year post injury High level = C6-T7 AIS A vs. low level = T8-L2 AIS A or incomplete AIS B-D with abdominal innervation |
Reliability and validity of the tests | 15 | High |
| Alternating reach test = tapping table eight times fast with and without arm support Seated reach distance lateral left and right Upper body dressing | |||||||
| [30] | Chen et al. | Eight SCI T1-6 (high thoracic) 22 SCI T7-12 (low thoracic) |
Sitting stability static (unsupported 30 s) and dynamic (30 s maximum leaning to four sides) Time needed for functional activities: upper body dressing, lower body dressing and transfer. |
Low versus high thoracic SCI Trunk strength (hand held dynamometry), lesion level and trunk length in relation to sitting balance. |
CoP displacement static and dynamic (sum score for all directions) Time to complete functional tasks |
16 | High |
| Sitting balance in relation to functional tasks. | |||||||
| [31] | Curtis et al. | Seven athletes with spinal cord injury; four in IWBF class 1 and three in IWBF class 2, nine AB | Reaching in sagittal and transverse plane | IWBF class 1 and 2, AB Belt at thigh and trunk versus no belt |
Reaching distance in sagittal and transverse plane | 16 | High |
| [50] | De Abreu et al. | 11 SCI T2-L2, AIS A-C, six AB | Reaching in anterior-posterior direction seated on different cushion types | AB versus SCI Different cushion types |
Maximum reach Anterior displacement of the trunk Reaching time for 50%, 75% and 90% and maximum reach |
13 | Moderate-poor |
| [32] | Gauthier et al. | 15 SCI: 9 “Abdo” (levelT7 or lower or active contraction abdominals to generate trunk flexion) 6 “No Abdo” (level higher than T7, no active contraction abdominals to generate trunk flexion) 15 AB |
Move CoP to eight directions with 45° interval | AB vs SCI “Abdo” versus SCI “No Abdo” | OSI (Overall Stability Index) DSI (Direction Specific Index of Stability) |
17 | High |
| [51] | Harel et al. | Seven SCI T1-T11 AIS A-B Seven AB |
Static balance with eyes open (EO) and eyes closed (EC) Dynamic balance: leaning in multiple directions |
AB versus SCI | Sitting items Berg Balance Scale Modified functional reach test |
14 | Moderate-poor |
| Seated posturography: postural sway EO and EC Maximum excursion centre of gravity (CoG) and directional control | |||||||
| [33] | Janssen-Potten et al. | Ten SCI T2-8 (high) Ten SCI T9-12 (low) Ten AB |
Bimanual forward reaching task 15%, 30%, 75% and 90% of maximum | Standard chair (S) 7° tilt (7 T) 12° tilt (12 T) 22° recline (22R) |
Maximum reaching distance CoP displacement |
14 | Moderate-poor |
| EMG erector spinae T3, erector spinae T9, erector spinae L3, latissimus dorsi, trapezius pars ascendens, pectoralis major, serratus anterior, oblique abdominal muscles Reaction time and movement time | |||||||
| [33] | Janssen-Potten et al. | Ten SCI T2-8 (high) | Bimanual forward reaching task 90% of maximum | High and low SCI | CoP displacement | 15 | High |
| Ten SCI T9-12 (low) | Standard chair and 10° forward inclination | EMG erector spinae T3, erector spinae T9, erector spinae L3, latissimus dorsi, trapezius pars ascendens, pectoralis major, serratus anterior, oblique abdominal muscles Kinematics pelvis (tilt) |
|||||
| Ten AB | |||||||
| [34] | Janssen-Potten et al. | Ten SCI T9-12 (low T) Ten SCI L1-5 (L) Ten AB |
Bimanual forward reaching task 90% of maximum | Low T, L and AB With and without rigid footrest |
Maximum displacement CoP (CoP max) Movement time |
15 | High |
| EMG erector spinae T9, erector spinae L3, rectus abdominis, oblique abdominals, gluteus max, tensor fascia lata, rectus femoris, vastus lateralis, biceps femoris, semitendinosus, tibialis anterior, gastrocnemius medialis | |||||||
| [35] | Kamper et al. | Four SCI C5-7 (tetraplegia) Four SCI T2-9 (paraplegia) Five AB |
Tilting movement in frontal plane on servo controlled platform in standard WC | Tetraplegia-paraplegia-AB And tilting movements with high and low amplitude and acceleration |
Balance loss FLCP = fraction of limit of CoP movement Velocity of CoP displacement Kinematic data Kinetic data (torque of pelvis, lower trunk and upper trunk) |
17 | High |
| [36] | Kamper et al. | Four SCI C5-7 (tetraplegia) Four SCI T2-9 (paraplegia) Five AB |
Tilting movement in sagittal plane on servo controlled platform in standard WC | Tetraplegia-paraplegia-AB And tilting movements with high and low amplitude and acceleration |
Balance loss FLCP = fraction of limit of CoP movement Kinematic data |
17 | High |
| [52] | Kerk et al. | Six SCI T3-6, absent abdominal muscles | Sub maximal and maximal exercise test on wheelchair roller in own WC | With and without elastic abdominal binder | Pushing stroke parameters, physiologic parameters, trunk movement | 12 | Moderate-poor |
| [37] | Potten et al. | Ten SCI T2-8 (high) Ten SCI T9-12 (low) Ten AB |
Bimanual forward reaching task 15%, 30%, 75% and 90% maximum | High SCI, low SCI and AB | CoP displacement EMG serratus anterior, m. pectoralis major, latissimus dorsi, erector spinae T3, trapezius pars ascendens |
16 | High |
| [53] | Requejo et al. | Five SCI T4 and higher (high), five SCI T12 and lower (low) | Three pushing speeds (0.85, 1.03 and 1.21 m/s) and one self-selected speed, administering frequent small bumps | Low and high SCI, wheelchair with rear suspension (three types), and without rear suspension | Self-selected speed Vertical seat reaction force Head acceleration |
10 | Moderate-poor |
| [46] | Schantz et al. | Four SCI low thoracic, three SCI cervical | Comfortable and maximum pushing speed, maximum acceleration on gymnasium wooden floor | SCI low thoracic and SCI cervical | Maximum velocity and acceleration, EMG activity of arm muscles, trunk position and movement Reaction time Movement time EMG activity latissimus dorsi and trapezius pars ascendens |
8 | Moderate-poor |
| [54] | Seelen et al. | 15 SCI T4-T12 15 AB |
Reaching forward 30%, 60% and 90% of maximum after warning signal with and without cue | SCI and AB | 11 | Moderate-poor | |
| [55] | Seelen et al. | 15 SCI T2-8 (high) 15 SCI T9-12 (low) |
Bimanual forward reaching task 15%, 30%, 75% and 90% of maximum | High and low SCI in experiment 1; none (only AB) in 2 | CoP displacement EMG erector spinae T3, erector spinae T9, erector spinae L3, latissimus dorsi, trapezius pars ascendens, pectoralis major, serratus anterior, oblique abdominal muscles |
14 | Moderate-poor |
| 15 AB | |||||||
| Antero-posterior force component | |||||||
| [56] | Seelen et al. | Five SCI T4-T8 (high), seven SCI T9-T12 (low) | Releasing push button on lap Reaching forward bilaterally |
15%, 30%, 75% and 90% of maximum reach high and low SCI duration since SCI |
Reaction time Movement time |
13 | Moderate-poor |
| [47] | Seelen et al. | Five SCI T4-8 (high) Seven SCI T9-12 (low) |
Bimanual forward reaching task 15%, 30%, 75% and 90% of maximum | High and low SCI, different points in time Braced vs. non braced (post hoc) |
CoP displacement EMG erector spinae T3, erector spinae T9, erector spinae L3, latissimus dorsi, trapezius pars ascendens, pectoralis major, serratus anterior, oblique abdominal muscles |
13 | moderate-poor |
| [38] | Seelen et al. | 15 SCI T2-8 (high) 15 SCI T9-12 (low) 15 AB |
Bimanual forward reaching task 15%, 30%, 75% and 90% of maximum | High and low SCI | Reaction time, movement time CoP displacement |
15 | High |
| [44] | Serra-Anno et al. | 24 SCI higher than T9 (high); T9 and lower (low) 24 AB |
Static sitting balance (ST) with eyes open (EO) and eyes closed (EC) Dynamic sitting balance (SLT) |
High SCI, low SCI, AB | ST: signal amplitude, range, frequency spectrum in anterior-posterior and medial-lateral directions. SLT: maximum CoP displacement, efficient CoP displacement and normalised total excursion of CoP |
13 | Moderate-poor |
| [57] | Shin et al. | Seven SCI T10 and higher (high) 11 SCI T10-L1 (low) 18 AB |
Functional reach test: reaching as far as possible with dominant hand | High SCI, low SCI, AB | Functional reach, velocity and CoP trajectory, functional boundary | 13 | Moderate-poor |
| [39] | Triolo et al. | Eight SCI low (T5-10) and high (C6-7) with implanted neuroprosthesis. | Seated bimanual reach: 30 in. = desktop and 48 in. = high shelf, loaded (20% of unilateral shoulder flexion strength) lifting a light or an heavier object | High and low SCI Stimulation on and off, Strong and weak based on volitional trunk extension strength with stimulation | Unsupported bimanual reaching distance with and without stimulation. | 17 | High |
| [40] | Vanlandewijck et al. | 13 track athletes, three female no full trunk function, four male no full trunk function, six male full trunk function. Diagnosis: SCI, spina bifida, arthrogryposis, amputation | Maximum acceleration track and treadmill with 4× resistance | Male athletes full trunk function versus male athletes no full trunk function | Distance on track after 1, 2 and 3 s (m) and distance on ergometer after 1, 2 and 3 s (m) | 19 | High |
STROBE, strengthening the reporting of observational studies in epidemiology; SCI, patients with spinal cord injury; WC, wheelchair; AB, able bodied persons; C, cervical level; T, thoracic level; L, lumbar level; IWBF class, International Wheelchair Basketball Federation class; CoP, centre of pressure; AIS, American Spinal Injury Association (ASIA) Impairment Scale [54].
Articles with a total STROBE score ≥15 were included in the analysis.