Muscular, Skeletal, and Neural Adaptations Following Spinal Cord Injury

J Orthop Sports Phys Ther, 2002 · DOI: 10.2519/jospt.2002.32.2.65 · Published: February 1, 2002

Spinal Cord Injury Physiology Rehabilitation

Simple Explanation

Spinal cord injury leads to changes in muscles, bones, and the nervous system. These changes can affect rehabilitation and future treatments. Understanding how these systems adapt is crucial for improving care and preparing for potential cures. After a spinal cord injury, muscles can become faster and more easily fatigued. Bones can lose density, especially in the legs. The spinal cord itself can also reorganize. These changes may be preventable or reversible with the right interventions. Rehabilitation strategies should consider these adaptations to preserve the musculoskeletal system. By understanding how muscles, bones, and the spinal cord change after paralysis, healthcare professionals can make better decisions about treatment and technology.

Study Duration

Not specified

Participants

Individuals with acute and chronic spinal cord injury

Evidence Level

Not specified

Key Findings

1
Paralyzed muscles transform to faster myosin types, increasing contractile speeds and fatigue.
2
Bone mineral density decreases significantly in the first six months after paralysis, especially in trabecular bone-rich areas.
3
Spinal cord reorganization occurs, impacting H-reflex suppression, and these changes covary with muscle fatigability.

Research Summary

Spinal cord injury induces significant adaptations in the muscular, skeletal, and neural systems. These adaptations can hinder rehabilitation efforts and future treatment options if not properly addressed. Muscular adaptations include a shift towards faster, more fatigable muscle fibers. Skeletal adaptations are characterized by rapid bone mineral density loss, particularly in the lower extremities. Spinal cord reorganization also occurs, affecting reflex pathways. Understanding these adaptations is crucial for developing effective rehabilitation strategies. Interventions that preserve muscle mass, maintain bone density, and prevent abnormal spinal circuitry reorganization may improve the quality of life for individuals with paralysis.

Practical Implications

Rehabilitation Strategies

Rehabilitative strategies should be designed to preserve muscle and bone health below the level of injury.

Electrical Stimulation Parameters

Electrical stimulation parameters should be carefully chosen to optimize force generation while minimizing fatigue.

Early Intervention

Early training regimens may prevent or reverse maladaptive changes in muscle, bone, and spinal circuitry.

Study Limitations

1
Experimental data are lacking regarding the extent to which rehabilitative methods may influence these adaptations.
2
The precise molecular adaptations in human muscle after spinal cord injury have not been fully addressed.
3
Studies specific to humans with spinal cord injury are essential.

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