Fantozzi (2022) Aquatic Therapy after Incomplete Spinal Cord Injury Gait Initiation Analysis Using Inertial Sensors

Summary: Aquatic Therapy in Incomplete Spinal Cord Injury (iSCI) – Gait Initiation Analysis


The study “Aquatic Therapy after Incomplete Spinal Cord Injury: Gait Initiation Analysis Using Inertial Sensors” by Fantozzi et al. explores the benefits of aquatic therapy on gait initiation in patients with incomplete spinal cord injury (iSCI). This research is crucial as iSCI patients often experience challenges in motor control, making gait initiation a critical area of focus​​.

Study Aim

The primary objective was to compare gait initiation between dry land and water immersion conditions in iSCI patients, using wearable inertial measurement units (IMUs). The hypothesis was that different environments would promote diverse motor control strategies in these patients​​.


Participants included adults with iSCI, who met specific inclusion criteria related to age, injury level, and locomotion system. The experimental procedure involved performing gait initiation on land and in water on the same day. Four waterproof IMUs were positioned on participants to monitor movements​​.

Data Analysis

The study used the Mancini et al. algorithm for data analysis. This approach identifies anticipatory postural adjustment (APA) onset and offset from IMU-based measurements. Various temporal and acceleration-based measures, such as APA duration and root mean squared (RMS) accelerations, were computed for both dry-land and water conditions​​.


In water, participants exhibited an increased first step duration and decreased RMS accelerations for the upper and lower trunk. These findings suggest that aquatic conditions influence different control strategies during gait initiation, as compared to dry-land conditions​​.


The results indicate that aquatic therapy can be an effective intervention for iSCI patients, potentially offering a safer and more beneficial environment for gait initiation and overall motor control. This study provides a foundation for future research on aquatic therapy’s role in rehabilitation for iSCI patients​​.

Keywords: anticipatory postural adjustment; inertial measurement unit (IMU); wearable sensors; water activity; first step

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