Neurorehabilitation and Neural Repair

 

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This version was published on July 1, 2007
Neurorehabilitation and Neural Repair, Vol. 21, No. 4, 358-365 (2007)
DOI: 10.1177/1545968306295561

Reviews

Review Article: Plasticity of Spinal Centers in Spinal Cord Injury Patients: New Concepts for Gait Evaluation and Training

Giorgio Scivoletto, MD

IRCCS Fondazione S. Lucia, Rome, Italy, g.scivoletto{at}hsantalucia.it

Yuri Ivanenko

IRCCS Fondazione S. Lucia, Rome, Italy

Barbara Morganti, PhT

IRCCS Fondazione S. Lucia, Rome, Italy

Renato Grasso, MD

IRCCS Fondazione S. Lucia, Rome, Italy

Mirka Zago

IRCCS Fondazione S. Lucia, Rome, Italy

Francesco Lacquaniti, MD, PhD

IRCCS Fondazione S. Lucia, Rome, Italy, Department of Neuroscience, Tor Vergata University, Rome, Italy

John Ditunno, MD

Thomas Jefferson University, Philadelphia, PA, USA

Marco Molinari, MD, PhD

IRCCS Fondazione S. Lucia, Rome, Italy

Recent data on spinal cord plasticity after spinal cord injury (SCI) were reviewed to analyze the influence of training on the neurophysiological organization of locomotor spinal circuits in SCI patients. In particular, the authors studied the relationship between central pattern generators (CPGs) and motor neuron pool activation during gait. An analysis of the relations between locomotor recovery and compensatory mechanisms focuses on the hierarchical organization of gait parameters and allows characterizing kinematic parameters that are highly stable during different gait conditions and in recovered gait after SCI. The importance of training characteristics and the use of robotic/automated devices in gait recovery is analyzed and discussed. The role of CPG in defining kinematic gait parameters is summarized, and spatio-temporal maps of EMG activity during gait are used to clarify the role of CPG plasticity in sustaining gait recovery.

Key Words: Spinal cord injury • Neuronal plasticity • Central pattern generator • Walking rehabilitation


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