Swim Training Initiated Acutely after Spinal Cord Injury Is Ineffective and Induces Extravasation In and Around the Epicenter

Abstract

Activity-based rehabilitation is a promising strategy for improving functional recovery following spinal cord injury (SCI). While results from both clinical and animal studies have shown that a variety of approaches can be effective, debate still exists regarding the optimal post-injury period to apply rehabilitation. We recently demonstrated that rats with moderately severe thoracic contusive SCI can be re-trained to swim when training is initiated 2 weeks after injury and that swim training had no effect on the recovery of overground locomotion. We concluded that swim training is a task-specific model of post-SCI activity-based rehabilitation. In the present study, we ask if re-training initiated acutely is more or less effective than when initiated at 2 weeks post-injury. Using the Louisville Swim Scale, an 18-point swimming assessment, supplemented by kinematic assessment of hindlimb movement during swimming, we report that acute re-training is less effective than training initiated at 2 weeks. Using the bioluminescent protein luciferase as a blood-borne macromolecular marker, we also show a significant increase in extravasation in and around the site of SCI following only 8 min of swimming at 3 days post-injury. Taken together, these results suggest that acute re-training in a rat model of SCI may compromise rehabilitation efforts via mechanisms that may involve one or more secondary injury cascades, including acute spinal microvascular dysfunction.

Functional recovery in spinal cord injured rats using polypyrrole/iodine implants and treadmill training

“…Although different strategies of rehabilitation, such as swimming, bicycling, exercise via wheel running and TT have been applied in experimental models of TSCI with the aim to improve locomotion, not all of them have had a significant effect on functional recovery. Some authors showed no improvement in functional recovery assessed with the BBB scale using swimming as rehabilitation therapy, and compared with untrained animals with a TSCI by contusion since it has been proved that swimming induces extravasation in and around the site of injury [42]. Bicycling has been shown to help prevent muscle atrophy and restore the frequency-dependent depression of the H-reflex to the level of that of intact animals but without significant effects on the functional recovery in rats with spinal cord transection [43,44].…”

A Systematic Review of Exercise Training To Promote Locomotor Recovery in Animal Models of Spinal Cord Injury

“…This sensory feedback is thought to be important for weight support during training (Edgerton et al, 2004). Indeed, in this review swimming training, which lacks the limbloading phase, was beneficial only when at least cutaneous feedback was provided (i.e., by inverted centrifuge tubes; Kuerzi et al, 2010;Smith et al, 2009Smith et al, , 2006.…”

“…Blinded outcome measures were undertaken in 29% of complete and 54% of incomplete SCI studies (Carvalho et al, 2008;Engesser-Cesar et al, 2007;Erschbamer et al, 2006;Foret et al, 2010;Fouad et al, 2000;Ichiyama et al, 2009;Kubasak et al, 2008;Kuerzi et al, 2010;Lankhorst et al, 2001;Maier et al, 2009;Multon et al, 2003;Oh et al, 2009;Park et al, 2010;Singh et al, 2011;Smith et al, 2006;Tillakaratne et al, 2010;Timoszyk et al, 2005, Zhang et al, 2007. Histological analysis to confirm the extent of the lesion were performed in 76% of complete, but only 46% of incomplete SCI studies (Barriere et al, 2008;Boyce et al, 2007 Kuerzi et al, 2010;Lankhorst et al, 2001;Lee et al, 2010;Liu et al, 2008;Lovely et al, 1986;Maier et al, 2009;Moshonkina et al, 2002Moshonkina et al, , 2004Multon et al, 2003;Nothias et al, 2005;Park et al, 2010;Petruska et al, 2007;Singh et al, 2011;Smith et al, 1982Smith et al, ,2009Smith et al, ,2006Tillakaratne et al, 2010;Ung et al, 2010;Zhang et al, 2007). The three studies (7%; …”

“…(38%; Fouad et al, 2000;Goldshmit et al, 2008;Kuerzi et al, 2010;Liu et al, 2008;Maier et al, 2009;Multon et al, 2003;Park et al, 2010;Smith et al, 2006Smith et al, ,2009, and seven studies (29%) reported one session per day (Carvalho et al, 2009;Heng and de Leon, 2009;Ichiyama et al, 2009;Oh et al, 2009;Robert et al, 2010;Singh et al, 2011;Stevens et al, 2006). In 30% of the studies, the number of sessions per day did not apply due to the type of intervention used (i.e., environmental enrichment or voluntary wheel running).…”

“…Studies providing more than one training session per day had shorter sessions (3-10 min) than those with a single session per day (30-60 min). Like the complete SCI experiments, many (46%) of the studies employing incomplete SCI had exercise training 5 days per week, but three studies (Carvalho et al, 2008;Park et al, 2010;Smith et al, 2009) provided training on 6 days per week. The duration of the training program varied widely (1-40 weeks), although in most (80%) of the rat studies the animals were trained for 4-12 weeks.…”