The effect of footrests on sitting balance in paraplegic subjects

Arch Phys Med Rehabil. 2002 May;83(5):642-8. doi: 10.1053/apmr.2002.32437.


Objective: To test the hypothesis that footrests contribute to active control of sitting balance.

Design: Cross-sectional group study.

Setting: Rehabilitation center.

Participants: Ten persons with complete low thoracic (T9-12) spinal cord injury (SCI), 10 persons with complete lumbar (L1-5) SCI, and 10 matched able-bodied controls.

Intervention: An elastically suspended footrest.

Main outcome measures: Reaching distance, time needed to perform a bimanual forward-reaching movement, center of pressure displacement, and muscle activity.

Results: Controls performed the forward-reaching movement slower and with less forward acceleration of the center of mass (COM) in the chair with the elastic footrest. Furthermore, they revealed a typical change in muscle activity patterns when the solid footrest was replaced by the elastic one. Persons with SCI performed the forward-reaching movement equally fast in both footrest conditions, but those with lumbar SCI showed less forward acceleration of the COM, whereas persons with thoracic SCI revealed more forward acceleration of the COM in the chair with the elastic footrest. Muscle activity patterns in persons with SCI did not indicate alternative muscle use through possible compensations or reflex activity.

Conclusions: Regarding wheelchair design, footrest condition does not seem to affect the range in which manual activities of daily living can be performed, but it does affect how they are performed.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Electromyography
  • Female
  • Foot / physiopathology*
  • Humans
  • Male
  • Middle Aged
  • Muscle, Skeletal / physiopathology
  • Paraplegia / physiopathology*
  • Paraplegia / rehabilitation*
  • Postural Balance / physiology*
  • Posture / physiology*
  • Wheelchairs*