Effects of exercise on fitness and health of adults with spinal cord injury: A systematic review
Conclusions: Exercise improves fitness and cardiometabolic health of adults with chronic SCI. The evidence on effective exercise types, frequencies, intensities, and durations should be used to formulate exercise guidelines for adults with SCI.
Publication date: March–April 2019Source: Brain Stimulation, Volume 12, Issue 2Author(s): Yu-Kuang Wu, Sana Saeed, James M. Limonta, Eric Bailey, Matthew T. Maher, Noam Y. Harel
OBJECTIVEThe aim of this study was to determine the inter-rater reliability of the modified Medical Research Council (MRC) scale for grading motor function in patients with chronic incomplete spinal cord injury (SCI).METHODSTwo neurosurgical reside...
Introduction: A mounting approach for rewiring and strengthening the corticospinal system (CS) following a spinal injury is to augment activity-dependent mechanisms that promote adaptive plasticity in the spinal cord. Emerging therapies from our lab use patterned electrical stimulation of motor cortex (M1) alone and in combination with cervical trans-spinal direct current stimulation (tsDCS) in the rat to promote corticospinal axon outgrowth, to strengthen CS connections, and to restore skilled motor function.
Introduction: Spinal cord injury (SCI) results in a mixture of damaged and spared neural circuits. Activating spared nerve circuits augments neural plasticity. With this goal in mind, we aim to use a novel method of non-invasive cervical electrical stimulation (CES). CES activates nerve roots across multiple myotomes in both upper extremities simultaneously. To understand CES circuit interactions, we measured the effects of CES delivered alone or paired with transcranial magnetic stimulation (TMS), peripheral nerve stimulation (PNS), or volitional movement.
Introduction: Non-invasive repetitive brain and/or spinal stimulation have shown to be an effective neuromodulatory method that can promote neuroplasticity. For example, repetitive pulsed transspinal stimulation decreases the afferent-mediated motor evoked potential (MEP) facilitation, increases the subthreshold transcranial magnetic stimulation (TMS) mediated flexor reflex facilitation, and increases corticospinal excitability of arm and leg muscles in spinal intact and after spinal cord injury subjects (Knikou et al., 2015; Murray and Knikou, 2017).
Introduction: Tissue engineering and neuromodulation approaches have demonstrated limited recovery of motor function after spinal cord injury (SCI) in experimental models and clinical trials. Encouraging results using epidural electrical stimulation (EES) to elicit volitional control of motor function in humans with SCI has been largely attributed to the presence of functionally silent fibers and to the combination of EES with locomotor training. Currently there is limited knowledge on the mechanisms underlying EES efficacy.
Background: There is a long-standing interest in using non-invasive electrical stimulation in rehabilitation including after spinal cord injury. Neurophysiological measures in human trials show Transcutaneous Spinal Direct Current Stimulation (tSDCS) produces acute and lasting changes in corticospinal excitability, including after spinal cord injury. Importantly, animal (rodent) models of tSDCS following injury suggest therapeutic potential including measures of behavior and axonal outgrowth. In vitro studies show direct current stimulation modulates excitability and plasticity.
Object: To develop surface EMG-triggered closed loop stimulation for individuals with spinal cord injury. The system can detect muscles ’ EMG signals and trigger transcranial magnetic stimulation (TMS) and peripheral nerve stimulation (PNS)
Objective: The rationale for using transcranial current stimulation (tCS) to increase cortical excitability in individuals with cervical spinal cord injury (cSCI) may not be intuitively obvious. However, beyond damage to descending spinal tracts, cSCI is associated with maladaptive cortical reorganization thereby hindering the ability of the cortex to drive information through remaining spinal pathways. Early evidence suggests that transcranial direct current stimulation (tDCS) promotes neuroplasticity in persons with cSCI, resulting in increased motor evoked potential (MEP) amplitude and improved hand function.
The corticospinal tract is an important target for motor recovery in humans with spinal cord injury (SCI). Using noninvasive electrophysiological techniques we have demonstrated the presence of reorganization in corticospinal projections targeting spinal motor neurons of lower-limb muscles in individuals with chronic anatomically incomplete cervical SCI. Our physiological findings indicated that corticospinal transmission in leg muscles changes in a task-dependent manner and to a different extent in individuals with and without spasticity.