Rehabilitation of locomotion after spinal cord injury.pptVIP

Rehabilitation of locomotion after spinal cord injury Hubertus J.A. van Hedel? and Volker Dietz SCI Research, Spinal Cord Injury Center, University of Zurich, Balgrist University Hospital, Zurich, Switzerland Rehabilitation of locomotion after spinal cord injury Abstract Introduction Control of locomotion Ambulation after incomplete SCI Mechanisms contributing to improved locomotion Training interventions for improving walking Conclusions Abstract Central pattern generators (CPG) and supraspinal control. For regaining locomotor function, incomplete SCI subjects depend on visual input and additional attentional capacity to compensate. Task-specific functional training and manual or robotic assisted bodyweight supported treadmill training (BWSTT) have the same effectiveness. Keywords: Gait Central pattern generator (CPG) Motor control Physiotherapy Bodyweight supported treadmill training Introduction Peculiarity Epidemiology Social-economics burden The most attentive point of the patient Bladder and bowel control Upper extremity function The influencing factor of walking restoration Severity of the spinal injury The time after lesion Age at time of injury Control of locomotion A stepping output pattern can be generated by the intrinsic capability of the spinal cord in mammals. Mutually inhibitory connections between a pair of flexor and extensor “half-centres” on each side of the spinal cord. This is the foundation of CPG. Control of locomotion Control of locomotion CPG is also involved in locomotion in humans Neonatal stepping and prenatal coordinated whole body movements The similarity in spinal networks underlying locomotion as evoked by the stimulation of flexor reflex afferents in motor complete SCI Rhythmic movements in motor complete SCI subjects Coordinated leg movements observed after spinal cord stimulation in motor complete SCI subjects Control of locomotion In humans, supraspinal input is required for walking. Both the CPG and the reflex mechanisms t