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Locomotor training for walking after spinal cord injury

Nerys Brick1

  • 1Nerys Brick, MSc (Renal), BSc (Hons), PGCLT(HE) NMC, RN, member of the Cochrane Nursing Care Field (CNCF), Canterbury Christ Church University, Canterbury, Kent CT1 1QU, United Kingdom.

Orthopedic Nursing
|March 22, 2014
PubMed

Abstract:

Review question: What are the effects of locomotor training on improvement in walking in people with traumatic spinal cord injury (SCI)?

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Spinal cord injury progresses through two interconnected phases: primary injury and secondary injury.Primary InjuryPrimary injury happens at the moment of trauma and involves immediate mechanical damage to the spinal cord.Compression happens when broken vertebrae, herniated discs, or accumulating blood (such as a hematoma) press directly against the spinal cord, distorting its normal shape and function. In cases of contusion, the cord is bruised by a blunt force (like penetrating injuries or...
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Early Ischemia and Ionic ImbalanceWithin minutes of spinal cord injury, a secondary cascade begins, progressing over hours to weeks. Vascular damage reduces blood flow, causing ischemia and mitochondrial dysfunction. ATP depletion leads to ion pump failure, membrane depolarization, sodium influx, potassium efflux, and water accumulation, resulting in cellular swelling. Increased intracellular calcium further disrupts mitochondria and accelerates cellular injury.Excitotoxicity and Neuronal...
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