Abstract
The recovery of walking function is considered of extreme relevance both by patients and physicians. Consequently, in the recent years, recovery of locomotion become a major objective of new pharmacological and rehabilitative interventions. In the last decade, several pharmacological treatment and rehabilitative approaches have been initiated to enhance locomotion capacity of SCI patients. Basic science advances in regeneration of the central nervous system hold promise of further neurological and functional recovery to be studied in clinical trials. Therefore, a precise knowledge of the natural course of walking recovery after SCI and of the factors affecting the prognosis for recovery has become mandatory. In the present work we reviewed the prognostic factors for walking recovery, with particular attention paid to the clinical ones (neurological examination at admission, age, etiology gender, time course of recovery). The prognostic value of some instrumental examinations has also been reviewed. Based on these factors we suggest that a reliable prognosis for walking recovery is possible. Instrumental examinations, in particular evoked potentials could be useful to improve the prognosis.
Highlights
IntroductionWalking recovery is one of the main goals of patients after SCI: walking is rated at first place (together with bladder and bowel function) at least by patients with incomplete lesions (Ditunno et al, 2008a)
Walking recovery is one of the main goals of patients after SCI: walking is rated at first place at least by patients with incomplete lesions (Ditunno et al, 2008a)
In the present work we reviewed the prognostic factors for walking recovery, with particular attention paid to the clinical ones
Summary
Walking recovery is one of the main goals of patients after SCI: walking is rated at first place (together with bladder and bowel function) at least by patients with incomplete lesions (Ditunno et al, 2008a). An epidemiological study shows an increase of the number of patients with incomplete lesions (e.g., with chances of walking recovery) (Pagliacci et al, 2003). The recovery of ambulation has become the target of several pharmacological and rehabilitative approaches (Wernig and Muller, 1992; Domingo et al, 2012) and a precise evaluation of the natural recovery of walking and of the prognostic factors influencing this function has become mandatory (Steeves et al, 2007). In the present work we reviewed the effect of several clinical and demographic features on the prognosis for walking recovery. The effect of early pharmacological and surgical interventions on walking recovery will be examined Because one of the main problems of the acute phase of SCI is the lack of reliable examinations, we considered the prognostic value of neurophysiological and neuroimaging examinations.
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