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Trunk stability is essential to maintain upright posture and support functional movements. In this study, we aimed to characterize the muscle activity and movement patterns of trunk flexion during an arm reaching task in sitting healthy subjects and investigate whether trunk stability is affected by a startling acoustic stimulus (SAS). For these purposes, we calculated the electromyographic (EMG) onset latencies and amplitude parameters in 8 trunk, neck, and shoulder muscles, and the tilt angle and movement features from smartphone accelerometer signals recorded during trunk bending in 33 healthy volunteers. Two-way repeated measures ANOVAs were applied to examine the effects of SAS and target distance (15 cm vs 30 cm). We found that SAS markedly reduced the response time and EMG onset latencies of all muscles, without changing neither movement duration nor muscle recruitment pattern. Longer durations, higher tilt angles, and higher EMG amplitudes were observed at 30 cm compared to 15 cm. The accelerometer signals had a higher frequency content in SAS trials, suggesting reduced movement control. The proposed measures have helped to establish the trunk flexion pattern in arm reaching in healthy subjects, which could be useful for future objective assessment of trunk stability in patients with neurological affections.

Study Design: Retrospective case series., Objectives: The aim of this paper was to review the cases of SCI associated with human towers in the neurorehabilitation hospital Guttmann in Barcelona, clarify the mechanisms of these accidents and classify the injuries., Settings and Methods: Data and history were retrospectively reviewed to detect SCI patients injured from human tower accidents admitted at the Guttmann Institute, Barcelona, in the period 1965-2017, from patient histories and interviews with patients and their relatives., Results: In total, five men with SCI acquired from "human tower" accidents were admitted between 1988 and 2017. All of them were at the base of the tower. They were all injured at cervical level, with very severe injury (AIS-A in two, AIS-B in one, and AIS-C in two). Two died due to pneumonia associated to mechanical ventilation at 4 and 10 years post injury., Conclusion: Human tower is a rare cause of traumatic tetraplegia in Catalonia. People forming the base of the tower are at greater risk for injury. Moreover, in our case series, all accidents causing SCI occurred when the human tower was greater than seven levels and had over three participants at each level., Competing Interests: Compliance with ethical standardsThe authors declare that they have no conflict of interest.

Recent studies report high incidence of restless legs syndrome (RLS) in patients with spinal cord injury (SCI), who may also present pain and sensory disturbances. In the present manuscript, we examine and discuss diagnostic and treatment challenges of comorbid RLS and neuropathic pain (NP) in SCI. We evaluated seven men with a mean age of 55.6 (s.d.=14.0) years, with chronic complete or incomplete SCI at the thoracic or lumbar level, for complaints of sensory disturbances in the legs, which initially were attributed to drug-resistant NP. Because overlapped RLS was suspected, clinical evaluation of NP and RLS, serum ferritin and iron level assessment, and video polysomnographic (VPSG) studies were conducted. Pramipexole (0.18 mg q.d. -1 ) was added to treat RLS, and a follow-up was performed at 2 months. We found that in six subjects the RLS was comorbid with NP and in one subject the symptoms of RLS were misdiagnosed as NP. VPSG revealed periodic limb movements (PLMs) in all patients, including PLMs of the legs, arms or both. Serum ferritin was <50 ng ml -1 in two patients. RLS improved significantly after 2 months with pramipexole. On the basis of current findings, we recommend physicians to be aware of the comorbidity between RLS and NP secondary to SCI to include suitable diagnostic procedures and effective treatments.