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Thread: Ten frequently asked questions concerning cure of spinal cord injury

  1. #621
    I hope it's okey to post my questions here.

    I'm wondering about locomotive training to increase function. Does it matter if the axons through the injury site are sensory or motor function? And how is the change in the cns distributed between the spine and the brain?

    Further, is it correct to anticipate function closer to the injury site to get back first?

    Thanks in advance!
    Debating on CareCure is like participating in the special-olympics. You may win, but you're still disabled.

  2. #622
    Quote Originally Posted by void View Post
    I hope it's okey to post my questions here.

    I'm wondering about locomotive training to increase function. Does it matter if the axons through the injury site are sensory or motor function? And how is the change in the cns distributed between the spine and the brain?

    Further, is it correct to anticipate function closer to the injury site to get back first?

    Thanks in advance!
    void, I am sorry that I am late with my answer. I wrote something but got diverted and never posted it.
    1. Descending motor fibers are necessary and sufficient to initiate locomotion. Sensory input to the brain does not seem to be necessary but obviously is useful and important. People who can't feel their legs must look at them when they are walking up or down steps or when their are obstacles, so that they don't trip and fall.
    2. Afferent sensory input (i.e. from the legs) are important for continuing the locomotor activity. On the other hand, it is possible rhythmic motor activity going in the legs without any sensory input, i.e. "air-walking", if you have sufficient activation of the the central pattern generator.
    3. Yes, motor function from segments closer to the injury site should recover first in theory. In practice, this is not often the case. I have personally seen many patients get back their big toe function first before they get other muscles. It is usually the first muscle to recover voluntary function in the legs.

    Wise.

  3. #623
    Quote Originally Posted by Wise Young View Post
    void, I am sorry that I am late with my answer. I wrote something but got diverted and never posted it.
    1. Descending motor fibers are necessary and sufficient to initiate locomotion. Sensory input to the brain does not seem to be necessary but obviously is useful and important. People who can't feel their legs must look at them when they are walking up or down steps or when their are obstacles, so that they don't trip and fall.
    2. Afferent sensory input (i.e. from the legs) are important for continuing the locomotor activity. On the other hand, it is possible rhythmic motor activity going in the legs without any sensory input, i.e. "air-walking", if you have sufficient activation of the the central pattern generator.
    3. Yes, motor function from segments closer to the injury site should recover first in theory. In practice, this is not often the case. I have personally seen many patients get back their big toe function first before they get other muscles. It is usually the first muscle to recover voluntary function in the legs.

    Wise.
    No problem, I know you have been travelling. Thanks for the answers but I realize I should had rephrased my first question, I was more wondering about how dynamic the spine is. I understand this more asking for your opinios because of the lack of consensus(as often).
    But do you believe e.g. a sensory axon can be reprogrammed to function as a motor evoking axon? If not, just rectal sensation alone seems like a poor indicator of possibility to gain function function through locomotive training.

    Again, thanks!
    Debating on CareCure is like participating in the special-olympics. You may win, but you're still disabled.

  4. #624
    Having learned to walk again with canes, I can just say that it is a hard road I have taken and I am still on that road.
    Very few people understand what I am going through.
    But I am not complaining but happy to have my growing pains. Nerve pain precedes my recovery. Pins and needles in my toes and feet today!
    My advice to aspiring walkers is to start training, eat healthy food and change your lifestyle for healthier.
    If there is some magic treatment to grow nerves, you still need years of practise to grow your atrophied muscles back! No magic pills but hard work I am afraid!

  5. #625
    Quote Originally Posted by Able Guy View Post
    Having learned to walk again with canes, I can just say that it is a hard road I have taken and I am still on that road.
    Very few people understand what I am going through.
    But I am not complaining but happy to have my growing pains. Nerve pain precedes my recovery. Pins and needles in my toes and feet today!
    My advice to aspiring walkers is to start training, eat healthy food and change your lifestyle for healthier.
    If there is some magic treatment to grow nerves, you still need years of practise to grow your atrophied muscles back! No magic pills but hard work I am afraid!
    Great job man! And i think people with spasms have enough muscles on legs if their nerves were fixed they would start dunking the ball with ease.
    How can you train muscle that has no voluntary contraction and dont respond to stim ?

  6. #626
    Quote Originally Posted by Able Guy View Post
    Having learned to walk again with canes, I can just say that it is a hard road I have taken and I am still on that road.
    Very few people understand what I am going through.
    But I am not complaining but happy to have my growing pains. Nerve pain precedes my recovery. Pins and needles in my toes and feet today!
    My advice to aspiring walkers is to start training, eat healthy food and change your lifestyle for healthier.
    If there is some magic treatment to grow nerves, you still need years of practise to grow your atrophied muscles back! No magic pills but hard work I am afraid!
    I hear ya, but people like myself who are completes cant do anything below the injury
    T6 complete since 3/21/2012

  7. #627
    Quote Originally Posted by void View Post
    No problem, I know you have been travelling. Thanks for the answers but I realize I should had rephrased my first question, I was more wondering about how dynamic the spine is. I understand this more asking for your opinios because of the lack of consensus(as often).
    But do you believe e.g. a sensory axon can be reprogrammed to function as a motor evoking axon? If not, just rectal sensation alone seems like a poor indicator of possibility to gain function function through locomotive training.

    Again, thanks!
    Void,

    Unfortunately, it doesn't work that way. Sensory axons come from the dorsal root sensory ganglia. They do not activate muscles. Muscles are activated by motoneurons in the spinal cord.

    The relationship between anal sensation and motor recovery does seem to be fairly remote. However, what it reflects is that the presence of functioning axons going all the way to the lowest part of the spinal cord. According to the Dobkin, et al. study in 2006, if anal sensation is not associated with any lower limb motor activity (i.e. ASIA B), the likelihood of recovering walking is about 25%. If anal sensory function is associated with any motor activity in the legs (i.e. ASIA C), the likelihood of recovering walking is 90%.

    Wise.

  8. #628

    2006 Dobkin study: walking recovery

    Quote Originally Posted by Wise Young View Post
    Void,

    Unfortunately, it doesn't work that way. Sensory axons come from the dorsal root sensory ganglia. They do not activate muscles. Muscles are activated by motoneurons in the spinal cord.

    The relationship between anal sensation and motor recovery does seem to be fairly remote. However, what it reflects is that the presence of functioning axons going all the way to the lowest part of the spinal cord. According to the Dobkin, et al. study in 2006, if anal sensation is not associated with any lower limb motor activity (i.e. ASIA B), the likelihood of recovering walking is about 25%. If anal sensory function is associated with any motor activity in the legs (i.e. ASIA C), the likelihood of recovering walking is 90%.

    Wise.
    Sorry Wise, I was unable to find the study you refer to. Am I right in assuming it was carried out on people in the acute stage and that the findings concern people who were B or C immediately after injury?

  9. #629
    Quote Originally Posted by mamadavid View Post
    Sorry Wise, I was unable to find the study you refer to. Am I right in assuming it was carried out on people in the acute stage and that the findings concern people who were B or C immediately after injury?
    You are right. I attach the article. Wise.

  10. #630
    Wise, according to this page: http://www.fenexy.org/members.php?menu=10&lang=1
    Are you on their scientific committee. Since they're in a phase of assesing the methods most benificial. What therapy will you advocate for?

    thanks in advance/void
    Debating on CareCure is like participating in the special-olympics. You may win, but you're still disabled.

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