Quantifying unsupported sitting posture impairments in humans with cervical spinal cord injury using a head-mounted IMU sensor

Cross-sectional study. To evaluate unsupported sitting posture impairments and identify postural regulatory strategies in cervical spinal cord injury (cSCI) participants via a head-mounted IMU sensor. A research lab in the United States of America. cSCI participants and controls maintained postural stability during unsupported sitting with eyes either open or closed. The head-mounted IMU sensor recorded accelerometer data to calculate cumulative sway motion. The postural regulatory strategy was analyzed by assessing the normalized power spectral density (PSD) in four frequency bands: 0–0.1 Hz (visual regulation), 0.1–0.5 Hz (vestibular regulation), 0.5–1 Hz (cerebellar regulation), and >1 Hz (proprioception and muscle control). Significant increases in postural sway were observed in cSCI participants compared to controls during unsupported sitting. For cSCI participants, normalized PSD significantly increased in the low-frequency bands (0–0.1 Hz and 0.1–0.5 Hz) but decreased in the high-frequency band (>1 Hz) compared to controls. cSCI participants were more reliant on visual and vestibular systems for sitting balance, while depending less on proprioception and muscle control compared to controls. These findings suggest that the altered postural regulatory strategy is ineffective in maintaining postural stability during unsupported sitting, emphasizing the importance of proprioception and muscle control for seated postural stability in cSCI participants.