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Neural Plasticity
Volume 2012 (2012), Article ID 254948, 13 pages
http://dx.doi.org/10.1155/2012/254948
Review Article

Plasticity of Corticospinal Neural Control after Locomotor Training in Human Spinal Cord Injury

Maria Knikou1,2,3,4

1Graduate Center and Physical Therapy Department, College of Staten Island, City University of New York, Staten Island, NY 10314, USA
2Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
3Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL 60611-2654, USA
4Electrophysiological Analysis of Gait and Posture Laboratory, Rehabilitation Institute of Chicago, Chicago, IL 60611, USA

Received 14 February 2012; Revised 9 April 2012; Accepted 10 April 2012

Academic Editor: Marie-Hélène Canu

Copyright © 2012 Maria Knikou. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Spinal lesions substantially impair ambulation, occur generally in young and otherwise healthy individuals, and result in devastating effects on quality of life. Restoration of locomotion after damage to the spinal cord is challenging because axons of the damaged neurons do not regenerate spontaneously. Body-weight-supported treadmill training (BWSTT) is a therapeutic approach in which a person with a spinal cord injury (SCI) steps on a motorized treadmill while some body weight is removed through an upper body harness. BWSTT improves temporal gait parameters, muscle activation patterns, and clinical outcome measures in persons with SCI. These changes are likely the result of reorganization that occurs simultaneously in supraspinal and spinal cord neural circuits. This paper will focus on the cortical control of human locomotion and motor output, spinal reflex circuits, and spinal interneuronal circuits and how corticospinal control is reorganized after locomotor training in people with SCI. Based on neurophysiological studies, it is apparent that corticospinal plasticity is involved in restoration of locomotion after training. However, the neural mechanisms underlying restoration of lost voluntary motor function are not well understood and translational neuroscience research is needed so patient-orientated rehabilitation protocols to be developed.