Reflex conditioning: A new strategy for improving motor function after spinal cord injury

Ann N Y Acad Sci, 2010 · DOI: 10.1111/j.1749-6632.2010.05565.x · Published: June 1, 2010

Spinal Cord Injury Neurology Rehabilitation

Simple Explanation

Spinal reflex conditioning can change the size of reflexes, induce plasticity in the spinal cord, and modify locomotion. This offers a new therapeutic strategy for restoring function in people with spinal cord injury (SCI). This approach targets specific reflex pathways to either increase or decrease responsiveness, addressing the specific deficits of individuals with SCI. Reflex conditioning could re-educate the newly reconnected spinal cord, which is especially useful once clinically significant regeneration is achieved.

Study Duration

Not specified

Participants

Rats, Monkeys, Mice, Humans

Evidence Level

Not specified

Key Findings

1
H-reflex conditioning produces plasticity at multiple sites in the spinal cord, including the motoneuron, GABAergic terminals, and Ia afferent synaptic connection.
2
Mode-appropriate activity in the sensorimotor cortex descends via the corticospinal tract (CST) to induce spinal cord plasticity responsible for H-reflex changes.
3
Reflex conditioning affects locomotor function. H-reflexes elicited during locomotion were smaller in rats with decreased soleus H-reflexes and larger in rats with increased soleus H-reflexes.

Research Summary

The study reviews the changes within the spinal cord produced by reflex conditioning, the supraspinal areas, and spinal cord descending pathways involved in this learning process. Reflex conditioning affects locomotor function, and appropriate application of reflex conditioning can improve walking in rats with spinal cord injury. The paper introduces a current effort to use reflex conditioning to improve locomotion in people with spinal cord injuries.

Practical Implications

Therapeutic Strategy

Reflex conditioning offers a new therapeutic strategy for restoring function in people with SCI by addressing specific deficits through targeted reflex pathway modulation.

Re-education of Regenerated Spinal Cord

Reflex conditioning can provide a means of re-educating the newly reconnected spinal cord once clinically significant regeneration techniques are available.

Clinical Use

Reflex conditioning protocols could become an important new approach to restoring motor function in people with partial spinal cord injuries and other chronic neuromuscular disorders.

Study Limitations

1
The precise mechanisms of plasticity in sensorimotor cortex during H-reflex conditioning are not fully understood.
2
The long-term effects and stability of improved locomotion after reflex conditioning in spinal cord-injured rats require further investigation.
3
The generalizability of findings from animal models to humans with spinal cord injuries needs careful clinical validation.

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