About 20.6 million individuals suffer from complete or incomplete motor and/or sensory disability following spinal cord injury (SCI) worldwide. Natural neurologic recovery may occur, but it is limited and predicted by the clinical assessment (i.e., level and severity of the injury). Therefore, promoting recovery beyond what is expected is of high priority. Physical rehabilitation activities have focused on strengthening and compensating for identified motor deficits to support independence. In contrast, many neurorehabilitation strategies aiming to promote motor control of the paralyzed limbs by enhancing the plasticity of the damaged neural circuits following SCI have emerged. Although it is difficult to determine whether one approach is superior to another, a combination of different strategies have been shown to achieve greater benefit than individual therapy alone. In this chapter, the following topics will be reviewed: (1) SCI epidemiology and the challenge of neurorehabilitation following SCI; (2) the evidence showing that most injuries to the spinal cord in humans are anatomically incomplete; and (3) neuroplasticity-based neurorehabilitation strategies aiming to promote and/or enhance recovery of motor function through the strengthening of residual connections following SCI.

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Spinal Cord Injury

  • Sina Sangari,
  • Monica A. Perez

摘要

About 20.6 million individuals suffer from complete or incomplete motor and/or sensory disability following spinal cord injury (SCI) worldwide. Natural neurologic recovery may occur, but it is limited and predicted by the clinical assessment (i.e., level and severity of the injury). Therefore, promoting recovery beyond what is expected is of high priority. Physical rehabilitation activities have focused on strengthening and compensating for identified motor deficits to support independence. In contrast, many neurorehabilitation strategies aiming to promote motor control of the paralyzed limbs by enhancing the plasticity of the damaged neural circuits following SCI have emerged. Although it is difficult to determine whether one approach is superior to another, a combination of different strategies have been shown to achieve greater benefit than individual therapy alone. In this chapter, the following topics will be reviewed: (1) SCI epidemiology and the challenge of neurorehabilitation following SCI; (2) the evidence showing that most injuries to the spinal cord in humans are anatomically incomplete; and (3) neuroplasticity-based neurorehabilitation strategies aiming to promote and/or enhance recovery of motor function through the strengthening of residual connections following SCI.