Brain research bulletin
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Brain research bulletin · Jan 2009
ReviewClinical relevance of gait research applied to clinical trials in spinal cord injury.
The restoration of walking function following SCI is extremely important to consumers and has stimulated a response of new treatments by scientists, the pharmaceutical industry and clinical entrepreneurs. Several of the proposed interventions: (1) the use of functional electrical stimulation (FES) and (2) locomotor training have been examined in clinical trials and recent reviews of the scientific literature. Each of these interventions is based on research of human locomotion. ⋯ In addition to measures of walking function developed for FES interventions, the first randomized multicenter clinical trial on locomotor training in subacute SCI was recently published with an extensive review of these measures. In this study outcome measures of motor strength (impairment), balance, Walking Index for SCI (WISCI), speed, 5min walk (walking capacities) and locomotor functional independence measure (L-FIM), a disability measure all showed improvement in walking function based on the strategy of the response of activity based plasticity to step training. Although the scientific basis for this intervention will be covered in other articles in this series, the evolution of clinical outcome measures of walking function continues to be important for the determination of effectiveness in clinical trials.
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Brain research bulletin · Jan 2009
ReviewBody weight supported gait training: from laboratory to clinical setting.
After spinal cord injury (SCI) of the cat or rat neuronal centres below the level of lesion exhibit plasticity that can be exploited by specific training paradigms. In individuals with complete or incomplete SCI, human spinal locomotor centers can be activated by appropriate afferent input. This includes to facilitate and assist stepping movements of the legs and to provide body weight support (BWS) standing on a moving treadmill. ⋯ Since several years driven gait orthoses can provide a standardized locomotor training. In the future, if regeneration approaches can successfully be applied in human SCI, even individuals with complete SCI may recover walking ability with locomotor training. Presently, individuals with complete SCI, spinal neuronal circuits undergo a degradation of their function 1 year after injury.