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Neuroscientist. 2015 Apr;21(2):203-15. doi: 10.1177/1073858414527541. Epub 2014 Mar 17.

Restoring walking after spinal cord injury: operant conditioning of spinal reflexes can help.

Author information

1
Helen Hayes Hospital, New York State Department of Health, West Haverstraw, NY, USA Wadsworth Center, New York State Department of Health, Albany, NY, USA Department of Neurology, Neurological Institute, Columbia University, New York, NY, USA Department of Biomedical Sciences, State University of New York, Albany, NY, USA thompsona@helenhayeshosp.org.
2
Helen Hayes Hospital, New York State Department of Health, West Haverstraw, NY, USA Wadsworth Center, New York State Department of Health, Albany, NY, USA Department of Neurology, Neurological Institute, Columbia University, New York, NY, USA Department of Biomedical Sciences, State University of New York, Albany, NY, USA.

Abstract

People with incomplete spinal cord injury (SCI) frequently suffer motor disabilities due to spasticity and poor muscle control, even after conventional therapy. Abnormal spinal reflex activity often contributes to these problems. Operant conditioning of spinal reflexes, which can target plasticity to specific reflex pathways, can enhance recovery. In rats in which a right lateral column lesion had weakened right stance and produced an asymmetrical gait, up-conditioning of the right soleus H-reflex, which increased muscle spindle afferent excitation of soleus, strengthened right stance and eliminated the asymmetry. In people with hyperreflexia due to incomplete SCI, down-conditioning of the soleus H-reflex improved walking speed and symmetry. Furthermore, modulation of electromyographic activity during walking improved bilaterally, indicating that a protocol that targets plasticity to a specific pathway can trigger widespread plasticity that improves recovery far beyond that attributable to the change in the targeted pathway. These improvements were apparent to people in their daily lives. They reported walking faster and farther, and noted less spasticity and better balance. Operant conditioning protocols could be developed to modify other spinal reflexes or corticospinal connections; and could be combined with other therapies to enhance recovery in people with SCI or other neuromuscular disorders.

KEYWORDS:

learning; locomotion; spinal cord injury; spinal cord plasticity; spinal reflexes

PMID:
24636954
PMCID:
PMC4167198
DOI:
10.1177/1073858414527541
[Indexed for MEDLINE]
Free PMC Article

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