Task-specificity vs. ceiling effect: Step-training in shallow water after spinal cord injury
Task-specificity vs. ceiling effect: Step-training in shallow water after spinal cord injury
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DOI：
10.1016/j.expneurol.2010.03.008
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发表时间：
2010-07-01
影响因子：
5.3
通讯作者：
Magnuson, D. S. K.
中科院分区：
文献类型：
--
作者：
Kuerzi, J.;Brown, E. H.;Magnuson, D. S. K.
虽然基于活动的康复是脊髓损伤最有前途的治疗方法之一，但最佳运动再训练的必要组成部分尚未确定。目前，正在研究许多不同的基于活动的方法，包括体重支持的跑步机训练（有和没有手动辅助），机器人辅助跑步机训练，骑自行车和游泳等。我们最近在成年大鼠中表明，基于游泳的强化康复在游泳期间带来后肢表现的显著改善，但不改变地上行走的正常恢复过程（Smith等人，2006 a，B，2009）。然而，游泳缺乏阶段性的肢体负荷和足底皮肤反馈被认为是重要的重量支持的步骤训练。因此，我们正在研究一种基于在浅水中行走的创新方法，其中浮力提供了一些体重支撑和平衡，同时仍然允许在再训练期间进行肢体负载和适当的皮肤传入反馈。因此，本研究的目的是确定脊髓损伤的动物在浅水中进行强化的体重支持运动训练后是否表现出改善的地上运动。结果表明，在浅水中的训练成功地提高了在浅水中的踏步，但值得注意的是，尽管事实上，浅水提供了足够的体重支持，让急性受伤的大鼠产生频繁的足底踏步地上运动带来显着的改善。这些观察结果支持先前的建议，即不完全受伤的动物在笼子里走动时重新训练自己，并且由于天花板效应而不是任务特异性本身，日常训练方案无法改善这种已经很大的功能改善。这些结果也支持的概念，中度至重度胸挫伤降低的能力，体重的支持，但不降低的能力，图案的生成。相比之下，严重挫伤的动物无法支撑其体重，也无法在通过浮力提供体重支撑时产生运动模式。(C)2010年爱思唯尔公司All rights reserved.
While activity-based rehabilitation is one of the most promising therapeutic approaches for spinal cord injury, the necessary components for optimal locomotor retraining have not yet been determined. Currently, a number of different activity-based approaches are being investigated including body weight-supported treadmill training (with and without manual assistance), robotically-assisted treadmill training, bicycling and swimming, among others. We recently showed, in the adult rat, that intensive rehabilitation based on swimming brought about significant improvements in hindlimb performance during swimming but did not alter the normal course of recovery of over-ground walking (Smith et al., 2006a,b, 2009). However, swimming lacks the phasic limb-loading and plantar cutaneous feedback thought to be important for weight-supported Step training. SO, we are investigating an innovative approach based on walking in shallow water where buoyancy provides some body weight support and balance while still allowing for limb-loading and appropriate cutaneous afferent feedback during retraining. Thus, the aim of this study is to determine if spinal cord injured animals show improved overground locomotion following intensive body weight-supported locomotor training in shallow water. The results show that training in shallow water successfully improved stepping in shallow water, but was notable to bring about significant improvements in overground locomotion despite the fact that the shallow water provides sufficient body weight support to allow acutely injured rats to generate frequent plantar stepping. These observations support previous suggestions that incompletely injured animals retrain themselves while moving about in their cages and that daily training regimes are not able to improve upon this already substantial functional improvement due to a ceiling effect, rather than task-specificity, per se. These results also support the concept that moderately-severe thoracic contusion injuries decrease the capacity for body weight support, but do not decrease the capacity for pattern generation. In contrast, animals with severe contusion injuries could not support their body weight nor could they generate a locomotor pattern when provided with body weight support via buoyancy. (C) 2010 Elsevier Inc. All rights reserved.