A new age for rehabilitation

Area of Science:

• Neuroscience
• Regenerative Medicine
• Rehabilitation Science

Background:

• Severe spinal cord injury (SCI) often results in profound motor deficits.
• Current rehabilitation strategies have limitations in restoring lost motor function.
• Understanding neural plasticity and recovery mechanisms is crucial for developing effective interventions.

Purpose of the Study:

• To review newly developed techniques for motor function recovery after severe SCI.
• To explore the combination of pharmacological neuromodulation, epidural stimulation, and motor training.
• To elucidate the mechanisms underlying regained motor control and functional connectivity.

Main Methods:

• Pharmacological neuromodulation to increase spinal cord excitability.
• Epidural stimulation of spinal cord circuitries.
• Intensive motor training programs.
• Analysis of regained functional connectivity between the brain and spinal cord.

Main Results:

• Combined interventions enable spinal circuits to interpret and respond to sensory input for motor control.
• Neuromodulation facilitates functional reconnection between the brain and spinal cord below the lesion.
• Voluntary movement control has been observed in individuals with complete paralysis during epidural stimulation.
• Insights from animal models provide a basis for understanding human SCI recovery.

Conclusions:

• Novel combinations of neuromodulation and motor training offer unprecedented potential for motor function recovery post-SCI.
• These approaches leverage the inherent plasticity of spinal cord circuitry.
• Further research into these techniques could lead to significant advancements in SCI rehabilitation.