Introduction to Gait Rehabilitation in Spinal Cord Injury: Difference between revisions
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== Plasticity-Based Approach == | == Plasticity-Based Approach == | ||
activity-dependent neural adaptation and training. The activity-dependent plasticity of the spinal cord and the role of the afferent input to the neurobiological control of walking. <ref>Van de Crommert HW, Mulder T, Duysens J. Neural control of locomotion: sensory control of the central pattern generator and its relation to treadmill training. Gait Posture. 1998 May 1;7(3):251-263.</ref>Study by Sherrington<ref>Sherrington CS. Flexion-reflex of the limb, crossed extension-reflex, and reflex stepping and standing. J Physiol. 1910 Apr 26;40(1-2):28-121. </ref>, Grillner and Rossignol <ref>Grillner S, Rossignol S. On the initiation of the swing phase of locomotion in chronic spinal cats. Brain Res. 1978 May 12;146(2):269-77. </ref> looked at the input of hip position and the effect of load on retraining walking after SCI | |||
develop rehabilitative strategies that emphasize the provision of hip extension and load, as well as other sensory elements contributing to the control of walking. | |||
intense practice of the specific task, locomotion; providing appropriate sensory input (loading and unloading, trunk posture, hip extension, limb kinematics) associated with the locomotor task to tap the intrinsic neural networks generating stepping activity; permissiveness of the training environment (treadmill speed, body-weight support [BWS]) to enhance practice of the locomotor task; integration of postural control as a corequisite for locomotion; and minimizing compensation (load bearing through the legs versus load bearing through the arms, hip hiking for swing) | |||
=== Locomotor Training === | |||
Goal: to generate stepping in response to specific afferent input associated with the task of walking | |||
General guidelines: to maximize loading of the lower limbs through body-weight support systems or overground walking with assistive devices | |||
== Compensatory-Based Approach == | == Compensatory-Based Approach == | ||
"compensation as a rehabilitation strategy for nonremediable deficits of strength (force-generating capacity), voluntary motor control, sensation, and balance". | |||
patient learns to compensate, using other abilities to complete a task, or to modify the task or the environment to accomplish the goal | |||
outcomes based on the degree of motor and sensory loss from total to partial | |||
to support and compensate for paresis or paralysis using braces and assistive devices; to teach new movement strategies to accomplish activities of daily living, including dressing, transfers, and bed mobility; to teach new strategies for upright mobility that incorporate braces and assistive devices; and to teach wheelchair mobility skills. | |||
== | == Predictors for Functional Outcome of Walking == | ||
== Assistive Devices == | == Assistive Devices == | ||
Revision as of 23:35, 8 January 2024
Original Editor - User Name
Top Contributors - Ewa Jaraczewska, Jess Bell and Kim Jackson
Introduction[edit | edit source]
Plasticity-Based Approach[edit | edit source]
activity-dependent neural adaptation and training. The activity-dependent plasticity of the spinal cord and the role of the afferent input to the neurobiological control of walking. [1]Study by Sherrington[2], Grillner and Rossignol [3] looked at the input of hip position and the effect of load on retraining walking after SCI
develop rehabilitative strategies that emphasize the provision of hip extension and load, as well as other sensory elements contributing to the control of walking.
intense practice of the specific task, locomotion; providing appropriate sensory input (loading and unloading, trunk posture, hip extension, limb kinematics) associated with the locomotor task to tap the intrinsic neural networks generating stepping activity; permissiveness of the training environment (treadmill speed, body-weight support [BWS]) to enhance practice of the locomotor task; integration of postural control as a corequisite for locomotion; and minimizing compensation (load bearing through the legs versus load bearing through the arms, hip hiking for swing)
Locomotor Training[edit | edit source]
Goal: to generate stepping in response to specific afferent input associated with the task of walking
General guidelines: to maximize loading of the lower limbs through body-weight support systems or overground walking with assistive devices
Compensatory-Based Approach[edit | edit source]
"compensation as a rehabilitation strategy for nonremediable deficits of strength (force-generating capacity), voluntary motor control, sensation, and balance".
patient learns to compensate, using other abilities to complete a task, or to modify the task or the environment to accomplish the goal
outcomes based on the degree of motor and sensory loss from total to partial
to support and compensate for paresis or paralysis using braces and assistive devices; to teach new movement strategies to accomplish activities of daily living, including dressing, transfers, and bed mobility; to teach new strategies for upright mobility that incorporate braces and assistive devices; and to teach wheelchair mobility skills.
Predictors for Functional Outcome of Walking[edit | edit source]
Assistive Devices[edit | edit source]
Orthosis[edit | edit source]
Ambulatory Devices[edit | edit source]
Resources[edit | edit source]
- bulleted list
- x
or
- numbered list
- x
References[edit | edit source]
- ↑ Van de Crommert HW, Mulder T, Duysens J. Neural control of locomotion: sensory control of the central pattern generator and its relation to treadmill training. Gait Posture. 1998 May 1;7(3):251-263.
- ↑ Sherrington CS. Flexion-reflex of the limb, crossed extension-reflex, and reflex stepping and standing. J Physiol. 1910 Apr 26;40(1-2):28-121.
- ↑ Grillner S, Rossignol S. On the initiation of the swing phase of locomotion in chronic spinal cats. Brain Res. 1978 May 12;146(2):269-77.
