Changes in supraspinal activation patterns following robotic locomotor therapy in motor-incomplete spinal cord injury

Patricia Winchester, Roderick McColl, Ross Querry, Nathan Foreman, James Mosby, Keith Tansey, Jon Williamson

Research output: Contribution to journalArticle

143 Scopus citations

Abstract

Objectives. Body weight-supported treadmill training (BWSTT) is a task-specific rehabilitation strategy that enhances functional locomotion in patients following spinal cord injury (SCI). Supraspinal centers may play an important role in the recovery of over-ground locomotor function in patients with motor-incomplete SCI. The purpose of this study was to evaluate the potential for supraspinal reorganization associated with 12 weeks of robotic BWSTT using functional magnetic resonance imaging (fMRI). Methods. Four men with motor-incomplete SCI participated in this study. Time since onset ranged from 14 weeks to 48 months post-SCI injury. All subjects were trained with BWSTT 3 times weekly for 12 weeks. This training was preceded and followed by fMRI study of supraspinal activity during a movement task. Testing of locomotor disability included the Walking Index for Spinal Cord Injury (WISCI II) and over-ground gait speed. Results. All subjects demonstrated some degree of change in the blood-oxygen-level-dependent (BOLD) signal following BWSTT. fMRI results demonstrated greater activation in sensorimotor cortical regions (S1, S2) and cerebellar regions following BWSTT. Conclusions. Intensive task-specific rehabilitative training, such as robotic BWSTT, can promote supraspinal plasticity in the motor centers known to be involved in locomotion. Furthermore, improvement in over-ground locomotion is accompanied by an increased activation of the cerebellum.

Original languageEnglish (US)
Pages (from-to)313-324
Number of pages12
JournalNeurorehabilitation and Neural Repair
Volume19
Issue number4
DOIs
StatePublished - Dec 1 2005

Keywords

  • Cerebellum
  • Functional magnetic resonance imaging
  • Locomotor training
  • Motor cortex
  • Spinal cord injury
  • Supraspinal plasticity

ASJC Scopus subject areas

  • Rehabilitation
  • Neurology
  • Clinical Neurology

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