Spinal cord injury: time to move

Abstract

Progress continues in the development of reparative interventions to enhance recovery after experimental spinal cord injury (SCI) in animal models. 1 Thuret S Moon LD Gage FH Therapeutic interventions after spinal cord injury. Nat Rev Neurosci. 2006; 7: 628-643 Crossref PubMed Scopus (790) Google Scholar Although some of these treatments might be translatable to patients with moderate SCI, and are entering phase 1 or 2 clinical trials, evidence for the efficacy of any intervention designed to repair the injured human spinal cord is still lacking. 2 Dietz V Ready for human spinal cord repair?. Brain. 2008; 131: 2240-2242 Crossref PubMed Scopus (17) Google Scholar Instead, improvement of ambulatory function is routinely observed with activity-based rehabilitation in individuals who retain voluntary movements of the legs after SCI. 3 Dietz V Colombo G Jensen L Locomotor activity in spinal man. Lancet. 1994; 344: 1260-1263 Summary PubMed Scopus (329) Google Scholar , 4 Behrman AL Harkema SJ Locomotor training after human spinal cord injury: a series of case studies. Phys Ther. 2000; 80: 688-700 PubMed Google Scholar However, even intense training programmes have not resulted in functional recovery in patients with clinically motor complete SCI. 5 Harkema SJ Plasticity of interneuronal networks of the functionally isolated human spinal cord. Brain Res Rev. 2008; 57: 255-264 Crossref PubMed Scopus (132) Google Scholar Effect of epidural stimulation of the lumbosacral spinal cord on voluntary movement, standing, and assisted stepping after motor complete paraplegia: a case studyTask-specific training with epidural stimulation might reactivate previously silent spared neural circuits or promote plasticity. These interventions could be a viable clinical approach for functional recovery after severe paralysis. Full-Text PDF