Neurophysiological Characterization of Motor Recovery in Acute Spinal Cord Injury

Spinal Cord, 2011 · DOI: 10.1038/sc.2010.145 · Published: March 1, 2011

Simple Explanation

This study examines how motor control recovers after a spinal cord injury (SCI) using neurophysiological methods. The recovery of voluntary movement after SCI is typically tracked using clinical scales. These scales don't capture the rate of muscle recruitment or the activation of synergistic muscles. Using surface electromyography (sEMG), the study quantifies the return of motor unit recruitment over time and across multiple muscles to better understand recovery from SCI.

Study Duration

1-17 months

Participants

11 acute SCI admissions and 5 non-injured subjects

Evidence Level

Prospective cohort study

Key Findings

1
Overall, sEMG amplitudes were lower after SCI, and prime mover muscle voluntary recruitment was slower with disrupted multi-muscle patterns.
2
Recovery was observed in 9 of 11 subjects, showing increased sEMG amplitudes, more rapid prime mover muscle recruitment, and normalization of multi-muscle activation patterns.
3
The rate of increase was highly individualized, differing by limb, joint, and across the SCI group.

Research Summary

The study neurophysiologically characterizes motor control recovery after SCI using multi-muscle sEMG recordings during reflex and volitional motor tasks. Results showed that SCI subjects had lower sEMG amplitudes, slower prime mover muscle recruitment, and disrupted multi-muscle patterns compared to non-injured subjects. Recovery was tracked quantitatively using neurophysiological methods, showing increases in sEMG amplitudes, prime mover muscle recruitment rates, and normalization of multi-muscle activation patterns in most subjects.

Practical Implications

Quantitative Tracking of Recovery

Neurophysiological methods can quantitatively track the recovery of voluntary motor function in SCI patients, offering a more sensitive measure than clinical scales alone.

Individualized Recovery Patterns

The highly individualized nature of recovery highlights the need for personalized rehabilitation strategies tailored to each patient's specific recovery rate and pattern.

Improved Understanding of Motor Control

The study provides insights into the spatiotemporal aspects of motor control recovery, potentially informing the development of targeted interventions to enhance motor function after SCI.

Study Limitations

1
The rate of increase was highly individualized
2
fEMG parameters introduced here need to be compared to clinically-relevant measures of function to examine clinical and predictive capacity.
3
better temporal synchronization of fEMG and clinical assessment scale sessions is needed to better relate findings to currently recognized measures

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