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Strategies and lessons in spinal cord injury rehabilitation

  • Spinal Cord Injury Rehabilitation (CL. Sadowsky)
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Abstract

The spinal cord is often underappreciated as part of the central nervous system. Like the brain, the spinal cord can independently carry out relatively complex behaviors, such as left–right and flexor–extension alternation of the limbs, through activation of resident central pattern generator circuitry. Here the spinal cord integrates ascending or local proprioceptive information with descending sensory and volitional information. In the context of injury, portions of the isolated spinal cord may still be capable of carrying out sophisticated processing for sensorimotor function. Several modes of stimulation appear to activate the central pattern generating circuitry in SCI: treadmill stepping, magnetic stimulation, electrical stimulation, vibratory stimulation, and pharmacologic agents. Like the brain, the spinal cord is capable of classical and operant conditioning. This observation highlights the need for well-planned therapeutic interventions that work with the innate behavior of the cord and avoid maladaptive learning that can occur if noxious stimuli are present during rehabilitation. Patient-specific multimodal therapies that work with innate spinal cord behaviors are most likely to benefit patients with SCI.

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Acknowledgments

This review was made possible by generous support from the J. Yang & Family Foundation. The research described was conducted in the UCLA Clinical and Translational Research Center (CTRC), which was supported by NIH/National Center for Advancing Translational Science (NCATS) UCLA CTSI Grant Number UL1TR000124. D.C.L. is a 1999 Paul & Daisy Soros New American Fellow.

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  1. Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, 650 Charles E. Young Drive, Wasserman Building, Room 562, Los Angeles, CA, 90095, USA

    Tianyi Niu, William A. Alaynick & Daniel C. Lu

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  1. Tianyi Niu
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  3. Daniel C. Lu
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This article is part of the Topical Collection on Spinal Cord Injury Rehabilitation.

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Niu, T., Alaynick, W.A. & Lu, D.C. Strategies and lessons in spinal cord injury rehabilitation. Curr Phys Med Rehabil Rep 3, 206–213 (2015). https://doi.org/10.1007/s40141-015-0096-z

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