Rehabilitation of locomotion after spinal cord injury课件.ppt

Rehabilitation of locomotion after spinal cord injury;Rehabilitation of locomotion after spinal cord injury;Abstract;Keywords:;Introduction;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;Control of locomotion;In non-human primates, the amount of descending fibres required to perform simple stepping movements might be as little as 25% of the lateral or ventral white matter. In the chronic isolated spinal cord an exhaustion of motoneurons occurs during assisted locomotion. During automated BWSTT in chronic SCI subjects,a strong reduction in EMG activity, especially in the flexor muscles, can be observed during the first ten minutes of assisted walking.;Ambulation after incomplete SCI;Recovery of ambulation and mobility after spinal cord injury. Box and whisker plots showing the course of A, preferred walking speed (10 MWT) and B, the outdoor mobility item of the revised SCIM II. Stars: * P 0.0125; ** P 0.01; *** P 0.001. Please note, significant improvement could be observed without a change in median score, as outliers are not shown in this figure. N, number of observations.;Ambulation after incomplete SCI;Mechanisms contributing to improved locomotion;Neural plasticity;An improvement in leg muscle strength does not necessarily result in improved locomotion and vice versa. But they do have relationship.;Compensation;Regeneration and neural repair;Training interventions for improving walking;In the early phase Work on those limitations we mentioned Provide support in standing If leg and trunk strength improves Improve balance Weight-bearing The swing phase be facilitated manually by the physiotherapist or applying functional electrical stimulation (FES);;The patient could not take steps stretching exercises followed by 3