Strategies and lessons in spinal cord injury rehabilitation

Autor: William A. Alaynick, Tianyi Niu, Daniel C. Lu
Rok vydání: 2015
Předmět:
Zdroj: Current Physical Medicine and Rehabilitation Reports. 3:206-213
ISSN: 2167-4833
DOI: 10.1007/s40141-015-0096-z
Popis: 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.
Databáze: OpenAIRE
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