Development of quantitative and sensitive assessments of physiological and functional outcome during recovery from spinal cord injury: A clinical initiative

Ellaway, P. H., Kuppuswamy, A., Balasubramaniam, A. V., Maksimovic, R., Gall, A., Craggs, M. D., Mathias, C. J., Bacon, M., Prochazka, A., Kowalczewski, J., Conway, B. A., Galen, S., Catton, C. J., Allan, D. B., Curt, A., Wirth, B. and van Hedel, H. J. A. (2011) Development of quantitative and sensitive assessments of physiological and functional outcome during recovery from spinal cord injury: A clinical initiative. Brain Research Bulletin, 84 (4-5). pp. 343-357. ISSN 1873-2747

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Abstract

The ability to detect physiological changes associated with treatments to effect axonal regeneration, or novel rehabilitation strategies, for spinal cord injury will be challenging using the widely employed American Spinal Injuries Association (ASIA) impairment scales (AIS) for sensory and motor function. Despite many revisions to the AIS standard neurological assessment, there remains a perceived need for more sensitive, quantitative and objective outcome measures. The purpose of Stage 1 of the Clinical Initiative was to develop these tools and then, in Stage 2 to test them for reliability against natural recovery and treatments expected to produce functional improvements in those with complete or incomplete spinal cord injury (SCI). Here we review aspects of the progress made by four teams involved in Stage 2. The strategies employed by the individual teams were (1) application of repetitive transcranial magnetic stimulation (rTMS) to the motor cortex in stable (chronic) SCI with intent to induce functional improvement of upper limb function, (2) a tele-rehabilitation approach using functional electrical stimulation to provide hand opening and grip allowing incomplete SCI subjects to deploy an instrumented manipulandum for hand and arm exercises and to play computer games, (3) weight-assisted treadmill walking therapy (WAT) comparing outcomes in acute and chronic groups of incomplete SCI patients receiving robotic assisted treadmill therapy, and (4) longitudinal monitoring of the natural progress of recovery in incomplete SCI subjects using motor tests for the lower extremity to investigate strength and coordination.

Item Type:	Article
Faculty \ School:	Faculty of Medicine and Health Sciences > Allied Health Professions (former - to 2013)
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Rehabilitation
Depositing User:	EPrints Services
Date Deposited:	25 Nov 2010 11:13
Last Modified:	24 Sep 2024 09:00
URI:	https://ueaeprints.uea.ac.uk/id/eprint/15624
DOI:	10.1016/j.brainresbull.2010.08.007

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