Retraining the injured spinal cord

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Motor Control

Background:

• Spinal cord injury (SCI) disrupts supraspinal input, altering neuronal and synaptic function.
• The lumbrosacral spinal cord retains capacity for motor recovery post-SCI.
• Neurotransmitter systems undergo significant adaptations following SCI.

Purpose of the Study:

• To review concepts for rehabilitative strategies to improve posture and locomotion after SCI.
• To highlight the spinal cord's ability to interpret afferent information and generate motor tasks.
• To emphasize the role of training in motor ability acquisition and recovery.

Main Methods:

• Review of existing literature on spinal cord plasticity and motor recovery.
• Analysis of afferent and intraspinal activation patterns.
• Examination of robotic assistive devices for guiding limb kinematics and quantifying movement.
• Investigation of neurotransmitter system adaptations, including GABAergic and glycinergic pathways.

Main Results:

• The spinal cord can improve motor performance with exposure to standing and stepping patterns.
• Repetitive training significantly aids in reacquiring standing and stepping abilities post-SCI.
• Robotic devices can guide limb movements, facilitating adaptation to new motor patterns and providing kinematic data.
• SCI leads to adaptations in neurotransmitter systems; step training can modulate these changes.

Conclusions:

• The spinal cord demonstrates capacity to interpret complex sensory information and generate motor tasks.
• Motor ability is significantly influenced and can be improved through targeted training.
• Rehabilitative strategies leveraging sensory input and robotic assistance show promise for SCI recovery.