Locomotor Training: As a Treatment of Spinal Cord Injury and in the Progression of Neurologic Rehabilitation

Potential role of oxidative stress on the prescription of rehabilitation interventions in spinal cord injury

“…For BWSTT, training parameters in research studies have ranged from 2 to 5 times per week, 20-60 min per session for 2-48 weeks; 77 the number of training sessions can vary widely even within a single study. 80,81 Rehabilitation researchers are still challenged to establish the optimal training parameters required to achieve functional improvements. Considerations of the potential effects of oxidative stress in SCI will be an important factor in addressing this issue.…”

Gait-like vibration training improves gait abilities: a case report of a 62-year-old person with a chronic incomplete spinal cord injury

“…1,2 These afferents are essential for motor learning and adaptive plasticity during locomotor training. 3 The need to provide task-specific sensory afferents explains in part the development of task-oriented approaches such as treadmill training with or without body weight support, and robotic exoskeletons.…”

Response to ‘Randomised controlled trials do not always give the results we want but that doesn’t mean we should abandon randomised controlled trials’

“…This problem of not defining 'conventional' therapy was further aggravated by the fact that both the randomized control and the experimental groups were actually trained according to the very same locomotor principles ('rules' of spinal locomotion 9 ), similar in intensity and kinematics of aided limb settings: although on the treadmill BWS and upright positioning are conveniently maintained by the adjustable harness, during OG walking this support is delegated to 2-3 therapists and the patients themselves providing BWS via arm-supporting devices (like walking frames, rollator and parallel bars) Thus, not the novel principles, repeated context-related training of upright locomotion with defined joint and load settings of the limbs was tested but two ways to apply them, either aided OG or treadmill walking. 7,12,13 Thus, the efficacy of intensive OG training is to be expected; in fact, we had encountered a patient near completely motor-paralyzed below T6, who had learned some independent stepping by training in parallel bars (patient Z in Wernig and Müller 9 ). It is the merit of SCILT to have revealed, on a quantitative basis, that enriched OG walking can be quite effective (though not similarly practicable, see below).…”

“…Quite unfortunate, this randomized 'control' group was in the text referred to as to perform OG or 'conventional walking'; obviously, 'conventional' is used here in contrast to the (unconventional) novel 'treadmill walking'. 4,5 Later on 'conventional walking' and 'conventional therapy' were used as synonyms, 7,12,13 and many readers were led to conclude that the LB therapy was not better compared with 'conventional overground training'. 7,13,14 This is incorrect as (historical) conventional therapy did not at all foster regular upright walking for wheel chair-bound patients, and, 'conventional OG training' contained more aided OG walking than ever before, 'conventional' here referring to OG walking in contrast to LB training.…”

“…4,5 Later on 'conventional walking' and 'conventional therapy' were used as synonyms, 7,12,13 and many readers were led to conclude that the LB therapy was not better compared with 'conventional overground training'. 7,13,14 This is incorrect as (historical) conventional therapy did not at all foster regular upright walking for wheel chair-bound patients, and, 'conventional OG training' contained more aided OG walking than ever before, 'conventional' here referring to OG walking in contrast to LB training. This problem of not defining 'conventional' therapy was further aggravated by the fact that both the randomized control and the experimental groups were actually trained according to the very same locomotor principles ('rules' of spinal locomotion 9 ), similar in intensity and kinematics of aided limb settings: although on the treadmill BWS and upright positioning are conveniently maintained by the adjustable harness, during OG walking this support is delegated to 2-3 therapists and the patients themselves providing BWS via arm-supporting devices (like walking frames, rollator and parallel bars) Thus, not the novel principles, repeated context-related training of upright locomotion with defined joint and load settings of the limbs was tested but two ways to apply them, either aided OG or treadmill walking.…”