Profiling motor control in spinal cord injury: Moving towards individualized therapy and evidence-based care progression

The Journal of Spinal Cord Medicine, 2012 · DOI: 10.1179/2045772312Y.0000000040 · Published: September 1, 2012

Spinal Cord Injury Neurology Neurorehabilitation

Simple Explanation

This article discusses methods to characterize patients after spinal cord injury using neurophysiology. These methods could help tailor therapeutic interventions and track their effectiveness during neurorehabilitation. The loose relationship between therapeutic interventions and their clinical effects is highlighted, noting varied patient responses. The importance of timing, dosing, duration, sequencing, and combination of therapies is emphasized for optimal clinical benefit.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Not specified

Key Findings

1
Standard clinical scales often fail to capture the nuances of neurophysiological states or changes after spinal cord injury.
2
Poly-EMG and reflex testing can directly evaluate the residual, re-organized nervous system, offering insights into the impact of therapeutic interventions.
3
The Brain Motor Control Assessment (BMCA) provides a quantitative assessment of motor control and can relate it to functional capacity and motor recovery.

Research Summary

The article addresses methods to neurophysiologically characterize patients after spinal cord injury and proposes how those methods could be used to individualize therapeutic interventions and monitor their efficacy over the course of neurorehabilitation. Current methods for assessing patients with spinal cord injuries and how those assessments fall short of providing sufficient information about nervous system changes that occur either spontaneously after injury or as a result of our rehabilitation interventions. Neurophysiological assessments such as poly-EMG and reflex testing offer potential to track and guide therapeutic intervention, permitting individualized care.

Practical Implications

Individualized Therapy

Neurophysiological assessments can guide therapeutic interventions, tailoring care to each patient's unique injury and neurophysiological state.

Evidence-Based Progression

Real-time assessments during therapies like locomotor training can optimize training parameters for maximum neurological recovery.

Improved Outcome Measures

Using tools like BMCA can provide quantitative measures of motor control that correlate with functional capacity, allowing for more precise tracking of treatment effects.

Study Limitations

1
Current clinical scales are crude and may not reveal underlying neurophysiological states.
2
Poly-EMG has limitations due to technical considerations like electrode placement.
3
Comparing absolute voltages recorded between individuals can be difficult in poly-EMG.

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