Neuroplasticity after spinal cord injury and training: An emerging paradigm shift in rehabilitation and walking recovery
Neuroplasticity after spinal cord injury and training: An emerging paradigm shift in rehabilitation and walking recovery
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DOI：
10.2522/ptj.20050212
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发表时间：
2006-10-01
期刊：
影响因子：
3.2
通讯作者：
Nair, Preeti M.
中科院分区：
文献类型：
--
作者：
Behrman, Andrea L.;Bowden, Mark G.;Nair, Preeti M.
脊髓损伤后的物理康复一直基于神经系统是硬连线和不可修复的前提。基于这一假设，临床医生已经使用支架、辅助设备和轮椅来补偿无法补救的感觉运动缺陷，以实现直立和坐姿移动。然而，来自基础科学的证据表明，受伤后的中枢神经系统具有可塑性，可以学习，这一证据挑战了我们目前的假设。关于运动的证据尤其令人信服。这篇文章的目的是总结证据支持即将发生的范式转变，从补偿赤字康复作为一个代理人步行恢复。一种基于生理学的步行康复方法已经发展起来，翻译脊髓损伤后活动依赖性神经可塑性和步行的神经生物学控制的证据。通过神经科学家，临床医生和研究人员之间的合作，关键的康复概念正在出现，以活动为基础的治疗，以改善步行恢复，有希望的临床研究结果。
Physical rehabilitation after spinal cord injury has been based on the premise that the nervous system is hard-wired and irreparable. Upon this assumption, clinicians have compensated for irremediable sensorimotor deficits using braces, assistive devices, and wheelchairs to achieve upright and seated mobility. Evidence from basic science, however, demonstrates that the central nervous system after injury is malleable and can learn, and this evidence has challenged our current assumptions. The evidence is especially compelling concerning locomotion. The purpose of this perspective article is to summarize the evidence supporting an impending paradigm shift from compensation for deficits to rehabilitation as an agent for walking recovery. A physiologically based approach for the rehabilitation of walking has developed, translating evidence for activity-dependent neuroplasticity after spinal cord injury and the neurobiological control of walking. Advanced by partnerships among neuroscientists, clinicians, and researchers, critical rehabilitation concepts are emerging for activity-based therapy to improve walking recovery, with promising clinical findings.