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Neurorehabilitation and Neural Repair
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Article

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

Giorgio Scivoletto, MD1*, Yuri Ivanenko1, Barbara Morganti, PhT1, Renato Grasso, MD1, Mirka Zago1, Francesco Lacquaniti, MD, PhD2, John Ditunno, MD3, Marco Molinari, MD, PhD1

1 IRCCS Fondazione S. Lucia, Rome, Italy
2 IRCCS Fondazione S. Lucia, and Dept. of Neuroscience, Tor Vergata University, Rome, Italy
3 Thomas Jefferson University, Philadelphia, PA

* To whom correspondence should be addressed. E-mail: g.scivoletto{at}hsantalucia.it.


  Abstract
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.

First published on March 12, 2007, doi:10.1177/1545968306295561

Neurorehabilitation and Neural Repair 2007;21:358.

A more recent version of this article appeared on July 1, 2007

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