Trunk kinematics of individuals with spinal cord injury during sitting-based functional activities: a systematic review with meta-analysis

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 and established how trunk kinematics could inform the selection of rehabilitation techniques. A systematic search was conducted in MEDLINE, EMBASE, CINAHL-PLUS and Web of Science databases to identify relevant studies up to the 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.