Accelerating locomotor recovery after incomplete spinal injury

Ann N Y Acad Sci, 2013 · DOI: 10.1111/nyas.12061 · Published: April 1, 2013

Spinal Cord Injury Neurology Rehabilitation

Simple Explanation

A traumatic spinal injury can destroy cells, irreparably damage axons, and trigger a cascade of biochemical responses that increase the extent of injury. To restore locomotor function, researchers have investigated the use of treadmill-based training, robots, and electrical stimulation to tap into adaptive activity-dependent processes. This manuscript reviews the endogenous neural system response to injury, and reviews data and presents novel analyses of these from a rat model of contusion injury that demonstrates how a targeted intervention can accelerate recovery, presumably by engaging processes that underlie activity-dependent plasticity.

Study Duration

Not specified

Participants

Rat model of contusion injury

Evidence Level

Not specified

Key Findings

1
NMES trained animals have more symmetric gait than the untrained animals.
2
The data suggest that NMES accelerated recovery following injury.
3
Applying a very small dose of stimulation to a small number of muscles very soon following injury was able to accelerate recovery.

Research Summary

The complex time course of the various components of the endogenous response to injury provides the substrate for rehabilitation interventions. Results from clinical and basic science studies indicate that repetitive movements may promote functional recovery by tapping into the processes that underlie activity-dependent plasticity. Electrical stimulation therapy can accelerate recovery of function and can be readily implemented in the clinic.

Practical Implications

Accelerated Recovery

Targeted interventions, like NMES, can accelerate locomotor recovery after iSCI.

Clinical Translation

Electrical stimulation therapy can be readily implemented in the clinic.

Personalized Therapy

Adaptive stimulation paradigms may provide a greater degree of recovery by producing movement patterns similar to intact animals.

Study Limitations

1
Small sample size in some studies.
2
The course of recovery was not followed beyond the short-term intervention.
3
More complex stimulation patterns may be needed to increase the effect of recovery.

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