Plasticity of corticospinal neural control after locomotor training in human spinal cord injury

Neural Plast. 2012:2012:254948. doi: 10.1155/2012/254948. Epub 2012 Jun 4.

Abstract

Spinal lesions substantially impair ambulation, occur generally in young and otherwise healthy individuals, and result in devastating effects on quality of life. Restoration of locomotion after damage to the spinal cord is challenging because axons of the damaged neurons do not regenerate spontaneously. Body-weight-supported treadmill training (BWSTT) is a therapeutic approach in which a person with a spinal cord injury (SCI) steps on a motorized treadmill while some body weight is removed through an upper body harness. BWSTT improves temporal gait parameters, muscle activation patterns, and clinical outcome measures in persons with SCI. These changes are likely the result of reorganization that occurs simultaneously in supraspinal and spinal cord neural circuits. This paper will focus on the cortical control of human locomotion and motor output, spinal reflex circuits, and spinal interneuronal circuits and how corticospinal control is reorganized after locomotor training in people with SCI. Based on neurophysiological studies, it is apparent that corticospinal plasticity is involved in restoration of locomotion after training. However, the neural mechanisms underlying restoration of lost voluntary motor function are not well understood and translational neuroscience research is needed so patient-orientated rehabilitation protocols to be developed.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Exercise Therapy / instrumentation
  • Exercise Therapy / methods*
  • H-Reflex / physiology
  • Humans
  • Interneurons / physiology
  • Motor Activity / physiology*
  • Nerve Net / physiology
  • Neuronal Plasticity / physiology*
  • Pyramidal Tracts / physiology*
  • Spinal Cord Injuries / physiopathology*
  • Spinal Cord Injuries / rehabilitation*