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Thread: Body weight supported gait training: from laboratory to clinical setting.

  1. #1

    Body weight supported gait training: from laboratory to clinical setting.

    Brain Res Bull. 2008 Jul 30;76(5):459-63. Epub 2008 Mar 25.

    Body weight supported gait training: from laboratory to clinical setting.

    Dietz V.

    University Hospital Balgrist, Spinal Cord Injury Center, Forchstr. 340, CH-8008 Zurich, Switzerland. volker.dietz@balgrist.ch

    After spinal cord injury (SCI) of the cat or rat neuronal centres below the level of lesion exhibit plasticity that can be exploited by specific training paradigms. In individuals with complete or incomplete SCI, human spinal locomotor centers can be activated by appropriate afferent input. This includes to facilitate and assist stepping movements of the legs and to provide body weight support (BWS) standing on a moving treadmill. Individuals with incomplete SCI benefit from such a locomotor training such that they improve the ability to walk over ground. Load- and hip-joint-related afferent input seems to be of crucial importance for both the generation of a locomotor pattern and the effectiveness of the training. It appears to be a critical combination of afferent signals that is needed to generate and improve a locomotor pattern after SCI. Mobility of individuals after a SCI can be improved by taking advantage of the plasticity of spinal neuronal circuits and can be maintained with persistent locomotor activity. Since several years driven gait orthoses can provide a standardized locomotor training. In the future, if regeneration approaches can successfully be applied in human SCI, even individuals with complete SCI may recover walking ability with locomotor training. Presently, individuals with complete SCI, spinal neuronal circuits undergo a degradation of their function 1 year after injury.

    http://www.ncbi.nlm.nih.gov/pubmed/1...ubmed_RVDocSum
    “As the cast of villains in SCI is vast and collaborative, so too must be the chorus of hero's that rise to meet them” Ramer et al 2005

  2. #2
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    Good article. I wonder even with the degradation of spinal neuronal circuits after one year, if they could be started again or how bad is the degradation.

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    I didn't have much of a choice, after I got home, 6 months after the building fell on me. I had to walk to get in my house, I've been at it ever since too. When I got home supported weight training was just coming into being, and I didn't have the resources to go. But, I started at full weight, [ I'm not heavy] and little by little I got back. I can walk short distances unassisted, use a cane, now it's looking a little showy. I'm doing better, it would have been a lot easier, doing it weight supported, but, in the end I'm getting what I started out for. Push on. I wish I could find as easier way, I haven't.

  4. #4
    alhavel,
    Did you have a spinal cord injury? if so at what level? Not like we CHOSE to be in chairs... we all want to walk just as bad as the next person. I have an 11 month old baby, I have no choice either but that hasn't made things any quicker. Some may never recover to walking...but it has nothing to do with chosing.
    Last edited by fourstepfarm; 06-22-2008 at 12:11 AM.

  5. #5
    fourstep

    If you would have looked at his profile you would see that a building fell on him in 2003 causing a SCI.


    Eric Harness, CSCS
    Founder/President
    Neuro Ex, Inc
    Adaptive Performance and Neuro Recovery

  6. #6
    Senior Member patd's Avatar
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    I think I disagree with you fourstep.

    You say it has nothing to do with choosing, but none of us will get anything back unless we choose to go get it back. Of course there is no gaurantee. Wanting it back isn't the same, to me, as choosing to grind away and see what you can do.

    Working through the ungodly discomfort of SCI has to be a choice.

    Pat

  7. #7
    well said pat.
    working every day to get out of my chair.

  8. #8
    I guess that isn't what I meant. I work out 4 days a week for 2 hours. I choose to do that...but what I guess what I mean is there are lots of people who choose to work out and that might not get all the results they hoped for. That is just reality.
    It isnt't that easy for all of us to just get up and start walking, fully supporting our body.
    I reread the post I wrote and realized it sounded a bit harsh. Not meant that way...
    and oh Eric, it says building fell on him "doing all the damage." said nothing about SCI

  9. #9
    Date of injury (NA if not spinal-injured)?:
    12/6/2003


    Eric Harness, CSCS
    Founder/President
    Neuro Ex, Inc
    Adaptive Performance and Neuro Recovery

  10. #10
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    Yes it is spinal cord injury, the level? I'm not sure, I have 2 rods and 13 bolts holding me together, some brain injury from a crushed skull. nerve damage to the motor control to the eyes, [double vision] eye excersises keep that in check. 8 weeks in a coma, I really didn't and still don't remember the accident. Honestly hope I don't. As for choice, I pushed and still push, and I will say it's the hardest thing I ever did, never did my body feel so heavy. I was used to climbing up trees, no ladder, chainsaw in hand, no problem, 185 lbs. and than this. It's still harder than I ever imagined, just walking across a room. I feel like I have a truck transmission in my arms at all times. every time I get going good and feel I've made a great accomplishment, I go backwards just as fast, only to have to start all over again.

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