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Neurorehabilitation: Strategies of Lower Extremities Restoration

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Neurological Aspects of Spinal Cord Injury

Abstract

Treatment of acute spinal cord injury (SCI) comprises two major therapeutic concepts, which aim for either restoration or compensation. Both strategies aim to reach the highest level of quality of life, mainly reflected by independence and participation in social activities. Restoration in this context means to recover sensorimotor function, which has been impaired or abolished by an incomplete spinal cord or cauda equine lesion. Therefore, only in patients with spared sensorimotor axon pathways restorative strategies can be successfully employed. In contrast, compensation means to replace irreversibly lost function through an alternative strategy, e.g., wheelchair mobility will substitute for the mobility achieved through walking. A number of excellent textbooks describe compensatory strategies in SCI rehabilitation in detail. This chapter will focus on therapies to promote recovery of walking function.

In order to choose appropriate rehabilitative treatment strategies, a precise definition of realistic goals to be achieved in each patient is of utmost importance. Respective goals can only be determined once neurological dysfunction and functional deficits are properly assessed. Therefore, effective goal setting approaches and internationally accepted neurological and functional assessment schemes will be described. Accordingly, task specific therapies (e.g., body weight supported treadmill training), supporting therapies (conventional physical therapy targeting muscle strength, balance and trunk stability, functional electrical stimulation) and orthotic devices including wearable exoskeletons will be described.

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Authors and Affiliations

  1. Spinal Cord Injury Center, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany

    Cornelia Hensel, Ute Eck, Anne von Reumont, Rüdiger Rupp & Eva-Maria Schmidt

  2. Department for Orthopedic Surgery and Traumatology, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany

    Merkur Alimusaj & Rudolf Kaschuba

Authors
  1. Cornelia Hensel
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  2. Ute Eck
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  3. Merkur Alimusaj
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  4. Rudolf Kaschuba
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  5. Anne von Reumont
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  6. Rüdiger Rupp
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  7. Eva-Maria Schmidt
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Editors and Affiliations

  1. Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany

    Norbert Weidner

  2. Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany

    Rüdiger Rupp

  3. Methodist Rehabilitation Center, University of Mississippi Medical Center, Veterans Administration Medical Center, Jackson, Mississippi, USA

    Keith E. Tansey

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Hensel, C. et al. (2017). Neurorehabilitation: Strategies of Lower Extremities Restoration. In: Weidner, N., Rupp, R., Tansey, K. (eds) Neurological Aspects of Spinal Cord Injury. Springer, Cham. https://doi.org/10.1007/978-3-319-46293-6_23

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  • DOI: https://doi.org/10.1007/978-3-319-46293-6_23

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