A systematic review on the effects of pharmacological agents on walking function in people with spinal cord injury

J Neurotrauma, 2012 · DOI: 10.1089/neu.2011.2052 · Published: March 20, 2012

Spinal Cord Injury Pharmacology Rehabilitation

Simple Explanation

Studies on spinalized animals suggest that some medications can influence spinal cord receptors, potentially aiding coordinated movement. Other drugs may alleviate SCI-related issues like spasticity or demyelination, potentially enhancing walking ability. This review analyzes studies on how drugs affect walking in people with SCI, finding limited evidence that current drugs significantly help walking recovery. More research is necessary to fully understand how drugs, combined with gait training, can improve walking outcomes for individuals with SCI.

Study Duration

Not specified

Participants

Eleven studies met the inclusion criteria

Evidence Level

Systematic Review

Key Findings

1
One RCT provided Level 1 evidence that GM-1 ganglioside in combination with physical therapy improved motor scores, walking velocity and distance better than placebo and physical therapy in persons with incomplete SCI.
2
Multiple studies (Levels of Evidence 1–5) showed that Clonidine and Cyproheptadine may improve locomotor function and walking speed in severely impaired individuals with incomplete SCI.
3
There was also Level 1 evidence that 4-aminopyridine and L-Dopa were no better than placebo in helping to improve gait.

Research Summary

This systematic review evaluated the effects of pharmacological agents on walking function in individuals with spinal cord injury (SCI). The review found limited evidence supporting the use of pharmacological agents alone to facilitate walking recovery after SCI. The authors emphasize the need for further research to explore the combined effects of drugs and gait training on walking outcomes in people with SCI.

Practical Implications

Combined Therapies

Investigate the combined effects of pharmacological agents with intensive locomotor training to maximize walking recovery.

Personalized Medicine

Tailor pharmacological interventions based on individual patient characteristics, such as injury severity and time post-injury, to optimize treatment outcomes.

Careful Health Screening

Implement thorough health and drug screenings to ensure patient safety and minimize potential drug-drug interactions during pharmacological interventions.

Study Limitations

1
Small sample sizes in many studies
2
Heterogeneity in subject characteristics (injury chronicity, level and severity, age)
3
Varied outcome measures made comparisons difficult

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