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Retraining the injured spinal cordThe present review presents a series of concepts that may be useful in developing rehabilitative strategies to enhance recovery of posture and locomotion following spinal cord injury. First, the loss of supraspinal input results in a marked change in the functional efficacy of the remaining synapses and neurons of intraspinal and peripheral afferent (dorsal root ganglion) origin. Second, following a complete transection the lumbrosacral spinal cord can recover greater levels of motor performance if it has been exposed to the afferent and intraspinal activation patterns that are associated with standing and stepping. Third, the spinal cord can more readily reacquire the ability to stand and step following spinal cord transection with repetitive exposure to standing and stepping. Fourth, robotic assistive devices can be used to guide the kinematics of the limbs and thus expose the spinal cord to the new normal activity patterns associated with a particular motor task following spinal cord injury. In addition, such robotic assistive devices can provide immediate quantification of the limb kinematics. Fifth, the behavioural and physiological effects of spinal cord transection are reflected in adaptations in most, if not all, neurotransmitter systems in the lumbosacral spinal cord. Evidence is presented that both the GABAergic and glycinergic inhibitory systems are up-regulated following complete spinal cord transection and that step training results in some aspects of these transmitter systems being down-regulated towards control levels. These concepts and observations demonstrate that (a) the spinal cord can interpret complex afferent information and generate the appropriate motor task; and (b) motor ability can be defined to a large degree by training.
Document ID
20040112446
Acquisition Source
Legacy CDMS
Document Type
Reprint (Version printed in journal)
Authors
Edgerton, V. R.
(Brain Research Institute and Departments of Physiological Science and Neurobiology, University of California Los Angeles, CA 90095, United States)
Leon, R. D.
Harkema, S. J.
Hodgson, J. A.
London, N.
Reinkensmeyer, D. J.
Roy, R. R.
Talmadge, R. J.
Tillakaratne, N. J.
Timoszyk, W.
Tobin, A.
Date Acquired
August 21, 2013
Publication Date
May 15, 2001
Publication Information
Publication: The Journal of physiology
Volume: 533
Issue: Pt 1
ISSN: 0022-3751
Subject Category
Behavioral Sciences
Distribution Limits
Public
Copyright
Other
Keywords
NASA Discipline Musculoskeletal
Non-NASA Center
Review
Review Literature

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