Neural.Plasticity.After.Human.SCI英文电子书.pdf

PROGRESS IN CLINICAL NEUROSCIENCE Neural Plasticity after Human Spinal Cord Injury: Application of Locomotor Training to the Rehabilitation of Walking SUSAN J. HARKEMA Department of Neurology and the Brain Research Institute University of California, Los Angeles Recovery of locomotion has been considered unattainable following a clinically complete or severe incom- plete spinal cord injury even after conventional therapy. However, the locomotion of spinal animals can be improved by training that provides complex temporal patterns of sensory information related to stepping that is interpreted by the spinal cord. This review discusses the evidence that suggests human spinal net- works can integrate and interpret complex sensory signals to produce functional efferent output and adapt to repetitive training. Locomotor training, a new rehabilitative approach, is based on principles that promote the movement of limbs and trunk to generate sensory information consistent with locomotion to improve the potential for the recovery of walking after neurologic injury. NEUROSCIENTIST 7(5):455–468, 2001 KEY WORDS Human spinal cord injury, Locomotor training, Neural plasticity, Rehabilitation The adult mammalian lumbosacral spinal cord can re- than stepping (de Leon and others 1998a). The afferent learn to step in the absence of supraspinal input when signaling during stepping and standing is interpreted by sensory information associated with weight-bearing the spinal cord as unique patterns of sensory input for a stepping occurs periodically (Lovely and others 1986; given phase of the particular motor task. This ability to Barbeau and Rossignol 1987; Barbeau and others 1993; interpret these task-specific afferent inputs effectively de Leon and others 1998b). Th