{"id":3292,"date":"2024-05-28T13:00:59","date_gmt":"2024-05-28T11:00:59","guid":{"rendered":"https:\/\/www.ablehumanmotion.com\/spinal-cord-injury\/"},"modified":"2025-05-21T14:44:53","modified_gmt":"2025-05-21T12:44:53","slug":"spinal-cord-injury","status":"publish","type":"page","link":"https:\/\/www.ablehumanmotion.com\/en\/spinal-cord-injury\/","title":{"rendered":"Spinal Cord Injury"},"content":{"rendered":"\t\t
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Spinal Cord Injury<\/span><\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/section>\n\t\t
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What is SCI?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
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Spinal cord injury<\/b> (SCI) is a complex and life-changing disease, whose impact is not only limited to the patient but also affects family, clinical professionals, and society as well.<\/span><\/p>\n

SCI is defined as damage to the spinal cord from traumatic or non-traumatic causes1<\/sup><\/span>, which <\/span>disrupts the neural communication<\/b> between the brain and peripheral end organ of the body, resulting in varying degrees of sensorimotor loss2<\/sup><\/span>.<\/span><\/p>\n

To assess the sensory and motor impairments following an SCI, the American Spinal Injury Association Impairment Scale (AIS) of the International Standards for Neurological Classification of SCI (ISNCSCI) is used. This scale determines the severity and the <\/span>neurological level of injury (NLI)<\/b>, which refers to the lowest segment of the spinal cord with normal sensory and antigravity motor function3<\/sup><\/span>. AIS defines five grades of severity:<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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  • AIS A – Complete:<\/b> no sensory or motor function is preserved in the sacral segments S4\u2013S5.<\/span><\/li>\n
  • AIS B – Sensory Incomplete:<\/b> sensory but not motor function is preserved below the NLI and includes the sacral segments S4-S5.<\/span><\/li>\n
  • AIS C – Motor Incomplete:<\/b>motor incomplete with at least half of key muscle functions below NLI having a grade < 3.<\/span> <\/li>\n
  • AIS D – Motor Incomplete:<\/b> motor incomplete with at least half of key muscle functions below NLI having a grade \u2265 3<\/span><\/li>\n
  • AIS E – Normal:<\/b> sensation and motor function are normal.<\/li>\n<\/ul>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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    \n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"Rehabilitaci\u00f3n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
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    <\/span><\/span>Symptoms<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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    Depending on the severity and NLI, damage can result in temporary or permanent symptoms that may include4,5<\/sup>:<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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    • Loss of movement – <\/span>Paralysis or weakness in musculature<\/b>.<\/span><\/li>\n
    • Loss of sensation<\/b> – Numbness or tingling sensation.<\/span><\/li>\n
    • Spasticity <\/b>– Uncontrollable muscle spasms or stiffness.<\/span><\/li>\n
    • Loss of <\/span>bladder or bowel<\/b> control. <\/span> <\/li>\n
    • Chronic pain<\/b> – Neuropathic or musculoskeletal pain.<\/span><\/li>\n<\/ul>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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      Experiencing these symptoms can lead to a <\/span>loss of independence<\/b> and <\/span>lack of physical activity<\/b> due to limited mobility, putting the individual at <\/span>risk for numerous secondary health complications<\/b>. This includes cardiovascular disease6<\/sup><\/span>, muscle atrophy7<\/sup><\/span>, urinary tract infections, respiratory issues<\/span>8<\/sup><\/span>, skin breakdown due to pressure sores, increased neuropathic pain, contractures, and fractures due to osteoporosis<\/span>9<\/sup><\/span>, which can negatively impact the quality of life of those living with SCI. For this reason, the main <\/span>rehabilitation <\/b>goals for people with SCI include regaining independence and enhancing well-being by improving mobility function, which is highly relevant to participating in social and professional life.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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      Rehabilitation treatment<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
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      Rehabilitation is considered an integral part of the treatment process. Best clinical outcomes in people with SCI are achieved with <\/span>early mobilisation<\/b> and <\/span>intense rehabilitation<\/b> therapy under the guidance of physicians, physical therapists, and occupational therapists<\/span>10<\/sup><\/span>. <\/span><\/p>

      Exercise is considered essential for lifelong health maintenance after SCI. A primary objective of neurorehabilitation programs is to foment <\/span>physical activity in an upright position<\/b>. This not only enhances the patient\u2019s quality of life but also serves to prevent or alleviate potential <\/span>long-term health complications<\/b> stemming from physical inactivity<\/span>7-9<\/sup><\/span>.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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      For patients with motor incomplete injuries, restoration of motor function stands as a crucial rehabilitation goal. This is achieved with early mobilisation and progressive, repetitive, high-intensity gait training, based on the principles of <\/span>motor learning and neuroplasticity<\/b>. <\/span><\/p>

      Conventional rehabilitation strategies have focused on range of motion and stretching, active exercises, electrical stimulation, and functional training in daily mobility tasks<\/span>11<\/sup><\/span>. This includes physical interventions to promote aerobic fitness and muscle strength.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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      Conventional Gait Training after an SCI<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
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      Walking is a fundamental component of human movement requiring lower-limb activation to initiate steps and support the body\u2019s weight during load-bearing. This stimulates the cardiorespiratory system to increase the delivery of oxygen to working muscles. On the one hand, exercise is considered essential for lifelong health maintenance after SCI, with current <\/span>guidelines of physical activity<\/b> in people with SCI recommending a <\/span>minimum of 20 minutes <\/b> of moderate to vigorous-intensity activity per session, for two (or more) sessions per week, to achieve improvements in aerobic fitness. On the other hand, task-specific training in functional movements, such as transferring and <\/span>walking with multiple repetitions<\/b> of the tasks (high intensity) is required to <\/span>promote<\/b> neuroplasticity and <\/span>neuromuscular reeducation<\/b>. <\/span> <\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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      For persons with SCI, standing and walking capabilities are limited. Thus, the most common approach to deliver locomotion training is with <\/span>assistive devices<\/b>, like orthopaedic braces and orthoses (ie. Knee-Ankle-Foot Orthosis), or <\/span>body-weight support systems<\/b> (BWS) using a treadmill or walking overground, in which the patient is connected to a harness and limb movements are assisted by a therapist. <\/span> <\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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      Some of these techniques impose a <\/span>high physical burden on physiotherapists<\/b> since replicating the normal gait pattern can require 2 to 3 persons to manually control and assist the patient with trunk and limb kinematics through the gait cycle, which makes it difficult to provide in high doses<\/span>12,13<\/sup><\/span>. <\/span>Over the years, rehabilitation has evolved with new technology-driven interventions like robotic-assisted gait training to facilitate the delivery of gait therapy.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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      \n\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/span>\n\t\t\t\t\t\t\t\t<\/path><\/svg><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\tReferences<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t
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      1. Spinal Cord Injury. <\/b>World Health Organization (WHO). Published April 16, 2024. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/spinal-cord-injury<\/span><\/li>\n \t
      2. Preservation of functional descending input to paralyzed upper extremity muscles in motor complete cervical spinal cord injury. <\/b>Sharma P, Naglah A, Aslan S, et al. <\/span>Clin Neurophysiol<\/span><\/i>. 2023;150:56-68. doi:10.1016\/j.clinph.2023.03.003<\/span><\/li>\n \t
      3. International Standards for Neurological Classification of Spinal Cord Injury. <\/b>Rupp R, Biering-S\u00f8rensen F, Burns SP, et al. <\/span>Top Spinal Cord Inj Rehabil<\/span><\/i>. 2021;27(2):1-22. doi:10.46292\/sci2702-1<\/span><\/li>\n \t
      4. Spinal Cord Injury. <\/b>National Institute of Neurological Disorders and Stroke. Published November 28, 2023. https:\/\/www.ninds.nih.gov\/health-information\/disorders\/spinal-cord-injury#:%7E:text=Publications-,Definition,that%20surround%20the%20spinal%20cord<\/span><\/li>\n \t
      5. Spinal cord injury. <\/b>Mayo Clinic. Published December 10, 2023. https:\/\/www.mayoclinic.org\/diseases-conditions\/spinal-cord-injury\/symptoms-causes\/syc-20377890<\/span><\/li>\n \t
      6. Cardiovascular disease and spinal cord injury: results from a national population health survey. <\/b>Cragg JJ, Noonan VK, Krassioukov A, Borisoff J. <\/span>Neurology<\/span><\/i>. 2013;81(8):723-728. doi:10.1212\/WNL.0b013e3182a1aa68<\/span><\/li>\n \t
      7. Skeletal muscle atrophy and increased intramuscular fat after incomplete spinal cord injury. <\/b>Gorgey AS, Dudley GA. <\/span>Spinal Cord<\/span><\/i>. 2007;45(4):304-309. doi:10.1038\/sj.sc.3101968<\/span><\/li>\n \t
      8. Consequences of spinal cord injury on the sympathetic nervous system. <\/b>Wulf MJ, Tom VJ. <\/span>Front Cell Neurosci<\/span><\/i>. 2023;17:999253. doi:10.3389\/fncel.2023.999253<\/span><\/li>\n \t
      9. Effect of weight-bearing activities on bone mineral density in spinal cord injured patients during the period of the first two years. <\/b>Alekna V, Tamulaitiene M, Sinevicius T, Juocevicius A. <\/span>Spinal Cord<\/span><\/i>. 2008;46(11):727-732. doi:10.1038\/sc.2008.36<\/span><\/li>\n \t
      10. Spinal Cord Injuries. In: <\/b>StatPearls<\/i><\/b>. <\/b>Bennett J, M Das J, Emmady PD.StatPearls Publishing; 2024. Accessed April 30, 2024. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK560721\/<\/span><\/li>\n \t
      11. Lower Limb, Balance and Walking Following Spinal Cord Injury. <\/b>Lam T, Tse C, Sproule S, Eng JJ.Published online 2019. https:\/\/scireproject.com\/wp-content\/uploads\/2022\/02\/Lower-Limb-and-Walking-Chapter-Jun-10-2019-FINAL.pdf<\/span><\/li>\n \t
      12. Robot-assisted gait training (Lokomat) improves walking function and activity in people with spinal cord injury: a systematic review. <\/b>Nam KY, Kim HJ, Kwon BS, Park JW, Lee HJ, Yoo A. <\/span>J NeuroEngineering Rehabil<\/span><\/i>. 2017;14(1):24. doi:10.1186\/s12984-017-0232-3<\/span><\/li>\n \t
      13. Type and Timing of Rehabilitation Following Acute and Subacute Spinal Cord Injury: A Systematic Review. <\/b>Burns AS, Marino RJ, Kalsi-Ryan S, et al. Glob Spine J<\/i>. 2017;7(3_suppl):175S-194S. doi:10.1177\/2192568217703084<\/li>\n<\/ol><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
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        Information contained herein is not medical advice and should not be used as an alternative to speaking with your doctor. Discuss indications, contraindications, warnings, precautions, adverse events, and any further information with your healthcare professional.<\/span><\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

        Spinal Cord Injury What is SCI? Spinal cord injury (SCI) is a complex and life-changing disease, whose impact is not only limited to the patient but also affects family, clinical professionals, and society as well. SCI is defined as damage to the spinal cord from traumatic or non-traumatic causes1, which disrupts the neural communication between […]<\/p>\n","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"class_list":["post-3292","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.ablehumanmotion.com\/en\/wp-json\/wp\/v2\/pages\/3292","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ablehumanmotion.com\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.ablehumanmotion.com\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.ablehumanmotion.com\/en\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ablehumanmotion.com\/en\/wp-json\/wp\/v2\/comments?post=3292"}],"version-history":[{"count":57,"href":"https:\/\/www.ablehumanmotion.com\/en\/wp-json\/wp\/v2\/pages\/3292\/revisions"}],"predecessor-version":[{"id":43645,"href":"https:\/\/www.ablehumanmotion.com\/en\/wp-json\/wp\/v2\/pages\/3292\/revisions\/43645"}],"wp:attachment":[{"href":"https:\/\/www.ablehumanmotion.com\/en\/wp-json\/wp\/v2\/media?parent=3292"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}