Paraplegic ambulation: a systems point of view

Area of Science:

• Neuroscience
• Biomedical Engineering
• Rehabilitation Technology

Background:

• Complete spinal cord lesions disrupt descending motor control, impacting ambulation.
• Preserved neurophysiological systems distal to the lesion offer potential for restoring function.
• Engineering control systems analysis provides a framework for understanding and manipulating these systems.

Purpose of the Study:

• To analyze preserved neurophysiological systems relevant to walking after spinal cord injury.
• To outline theoretical concepts for neuromuscular electrical stimulation (NMES) in paraplegic ambulation.
• To review current developments and future possibilities for NMES-assisted walking.

Main Methods:

• Review of existing literature on neurophysiological systems distal to spinal lesions.
• Application of engineering control systems principles to understand motor control.
• Analysis of current and emerging NMES technologies for lower limb activation.

Main Results:

• Identification of key preserved neurophysiological pathways crucial for gait.
• Conceptual framework for NMES control strategies based on system analysis.
• Overview of technological advancements enabling NMES-based paraplegic locomotion.

Conclusions:

• Neurophysiological systems distal to spinal cord injury can be leveraged for ambulation.
• NMES presents a viable strategy for restoring walking in paraplegia.
• Further research and technological development are essential for optimizing NMES-assisted gait.