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Spinal cord injury (SCI) causes major challenges to mobility and daily life activities and maintaining balance becomes a crucial issue. Individuals with SCI often need to adopt new strategies to manage balance with minimal discomfort. Sports and physical activities have become one of the most popular rehabilitation methods for people with SCI. The assessment of balance improvement currently relies on subjective evaluation scales, and this study aims to quantitively assess the efficacy of sports on the balance strategies of people with SCI. Twenty-two SCI people remained seated still for 30 s, with their eyes open and closed, and we recorded trunk kinematics with an optoelectronic system before and after a three-months sports program. We also computed trunk total sway length, mean velocity, and sway density curve. Statistical analyses were performed to compare SCI people before and after the rehabilitation program and to investigate any correlations between the trunk balance parameters and the clinical scales. The results demonstrate improvements in static balance, with significant reductions in sway length and mean velocity. In conclusion, our findings confirm the potential of sports to enhance balance in SCI individuals and suggest that integrating structured sports programs into rehabilitation can improve stability and postural control.

Background: New wearable assistive devices (exoskeletons) have been developed for assisting people during work activity or rehabilitation. Although exoskeletons have been introduced into different occupational fields in an attempt to reduce the risk of work-related musculoskeletal disorders, the effectiveness of their use in workplaces still needs to be investigated. This systematic review focused on the effects of upper-body exoskeletons (UBEs) on human metabolic cost and thermophysiological response during upper-body work tasks., Methods: articles published until 22 September 2020 were selected from Scopus, Web of Science, and PubMed for eligibility and the potential risk of bias was assessed., Results: Nine articles resulted in being eligible for the metabolic aspects, and none for the thermal analysis. All the studies were based on comparisons between conditions with and without exoskeletons and considered a total of 94 participants (mainly males) performing tasks involving the trunk or overhead work, 7 back-support exoskeletons, and 1 upper-limb support exoskeleton. Eight studies found a significant reduction in the mean values of the metabolic or cardiorespiratory parameters considered and one found no differences., Conclusions: The reduction found represents a preliminary finding that needs to be confirmed in a wider range of conditions, especially in workplaces, where work tasks show different characteristics and durations compared to those simulated in the laboratory. Future developments should investigate the dependence of metabolic cost on specific UBE design approaches during tasks involving the trunk and the possible statistical correlation between the metabolic cost and the surface ElectroMyoGraphy (sEMG) parameters. Finally, it could be interesting to investigate the effect of exoskeletons on the human thermophysiological response.