A robot-based assessment of trunk control in Spinal Cord Injured athletes

Spinal Cord Injury (SCI) affects trunk control and determines altered or absent neuromuscular activity and sensory feedback below the lesioned spinal segment. The practice of sport or of any physical activity are key elements for improving the health and quality of life of people with SCI. Paralympic athletes overcome limits related to their injuries, achieving high neuromuscular control and coordination. Among the sports that have been adapted for people with disabilities, sit-skiing is a sport that requires good trunk control. However, there is a lack of instruments and protocols for its quantitative assessment. In this work we describe a robot-based protocol designed to assess trunk control and tested with two expert sit-skiers and eight unimpaired subjects. We used the robotic platform hunova® to evaluate both the active and the reactive component of trunk control through two different exercises. We investigated the strategy adopted by subjects to perform these exercises and the changes due to their repetition. All unimpaired subjects successfully completed the proposed protocol. The repetition of both exercises induced a learning process leading to differences in motor performance. Similar results could be observed also in the two athletes, whose performance was characterized by differences due to the severity of their lesion and their skiing skills.