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Recovery of control of posture and locomotion after a spinal cord injury: solutions staring us in the face

Fong, Andy J. and Roy, Roland R. and Ichiyama, Ronaldo M. and Lavrov, Igor and Courtine, Grégoire and Gerasimenko, Yury and Tai, Y. C. and Burdick, Joel and Edgerton, V. Reggie (2009) Recovery of control of posture and locomotion after a spinal cord injury: solutions staring us in the face. In: Progress in Brain Research. Neurotherapy: Progress in Restorative Neuroscience and Neurology . Vol.175. Elsevier , pp. 393-418. ISBN 978-0-12-374511-8.

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Over the past 20 years, tremendous advances have been made in the field of spinal cord injury research. Yet, consumed with individual pieces of the puzzle, we have failed as a community to grasp the magnitude of the sum of our findings. Our current knowledge should allow us to improve the lives of patients suffering from spinal cord injury. Advances in multiple areas have provided tools for pursuing effective combination of strategies for recovering stepping and standing after a severe spinal cord injury. Muscle physiology research has provided insight into how to maintain functional muscle properties after a spinal cord injury. Understanding the role of the spinal networks in processing sensory information that is important for the generation of motor functions has focused research on developing treatments that sharpen the sensitivity of the locomotor circuitry and that carefully manage the presentation of proprioceptive and cutaneous stimuli to favor recovery. Pharmacological facilitation or inhibition of neurotransmitter systems, spinal cord stimulation, and rehabilitative motor training, which all function by modulating the physiological state of the spinal circuitry, have emerged as promising approaches. Early technological developments, such as robotic training systems and high-density electrode arrays for stimulating the spinal cord, can significantly enhance the precision and minimize the invasiveness of treatment after an injury. Strategies that seek out the complementary effects of combination treatments and that efficiently integrate relevant technical advances in bioengineering represent an untapped potential and are likely to have an immediate impact. Herein, we review key findings in each of these areas of research and present a unified vision for moving forward. Much work remains, but we already have the capability, and more importantly, the responsibility, to help spinal cord injury patients now.

Item Type:Book Section
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Tai, Y. C.0000-0001-8529-106X
Additional Information:© 2009 Elsevier B.V. Available online 4 August 2009. The work presented in this paper was supported by the National Institutes of Health Grants NS16333 and NS42291, the Russian Foundation for Basic Research — US Civilian Research and Development Foundation Grant 07-04-91106, the Christopher and Diana Reeve Paralysis Foundation, and the Roman Reed Spinal Cord Injury Research Fund of California.
Funding AgencyGrant Number
Russian Foundation for Basic Research-US Civilian Research and Development Foundation Grant07-04-91106
Christopher and Diana Reeve Paralysis FoundationUNSPECIFIED
Roman Reed Spinal Cord Injury Research Fund of CaliforniaUNSPECIFIED
Subject Keywords:spinal cord injury; rehabilitation; robotic motor training; pharmacological intervention; skeletal muscle adaptation; proprioception; epidural stimulation; locomotion
Series Name:Neurotherapy: Progress in Restorative Neuroscience and Neurology
Record Number:CaltechAUTHORS:20100823-154128926
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Usage Policy:No commercial reproduction, distribution, display or performance rights in this work are provided.
ID Code:19604
Deposited By: Tony Diaz
Deposited On:26 Aug 2010 19:30
Last Modified:03 Oct 2019 01:59

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