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Thread: Plasticity of Spinal Centers in Spinal Cord Injury Patients: New Concepts for Gait Ev

  1. #1

    Plasticity of Spinal Centers in Spinal Cord Injury Patients: New Concepts for Gait Ev

    Neurorehabil Neural Repair. 2007 Mar 12;

    Plasticity of Spinal Centers in Spinal Cord Injury Patients: New Concepts for Gait Evaluation and Training.

    Scivoletto G, Ivanenko Y, Morganti B, Grasso R, Zago M, Lacquaniti F, Ditunno J, Molinari M.

    IRCCS Fondazione S. Lucia, Rome, Italy.

    Recent data on spinal cord plasticity after spinal cord injury (SCI) were reviewed to analyze the influence of training on the neurophysiological organization of locomotor spinal circuits in SCI patients. In particular, the authors studied the relationship between central pattern generators (CPGs) and motor neuron pool activation during gait. An analysis of the relations between locomotor recovery and compensatory mechanisms focuses on the hierarchical organization of gait parameters and allows characterizing kinematic parameters that are highly stable during different gait conditions and in recovered gait after SCI. The importance of training characteristics and the use of robotic/automated devices in gait recovery is analyzed and discussed. The role of CPG in defining kinematic gait parameters is summarized, and spatio-temporal maps of EMG activity during gait are used to clarify the role of CPG plasticity in sustaining gait recovery.

    PMID: 17353461 [PubMed - as supplied by publisher]

    Wildwilly
    “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
    Senior Member FasterNow's Avatar
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    Have you seen the results of this study? Are they available free somewhere?
    Injured 7-22-06, T-11 T-12 complete. [Holds up cardboard sign] "Will work for returns."
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  3. #3
    This is a 2007 review article so it provides a summary of results form recent clinical trials and pertinent animal research. I found the article very interesting in that it points out, confirms, and or hypothesizes that:

    1) CPGs are located through out the cord;
    2) Different motor neurons participate in recovery (one's that were not necessarily involved CPG of walking before the injury;
    3) Upper limb and trunk compensatory movement contribute to foot placement trajectory and the resulting gait pattern;
    4) Supraspinal control and cognitive aspects are relevant for gait training

    Additionally, they point out that compensatory mechanisms develop (new, altered, impaired CPG) with recovery from paralysis and during gait training. Therefore it is extremely important that clinicians and clinical investigators understand these mechanism so as to develop more efficient treatment strategies. Furthermore, I agree with their hypothesis that an increased focus on foot trajectory maybe more important/effective (in recovery of gait) than correcting the compensatory mechanisms of the proximal body (arm swing, trunk rotation…..). As long as you can protect the joint/tissue, I say go for it. There is a time and place for the clinician to be picky and clean up the quality of gait.

    Wildwilly
    “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

  4. #4
    This just goes to show how important accessable and affordable gait training is. Too many of us are probably capable of walking to some degree, yet a lack of access to gait training is keeping us sitting.
    "So I have stayed as I am, without regret, seperated from the normal human condition." Guy Sajer

  5. #5
    Where can I view the full text of this article?

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