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

P.H. Ellaway, A. Kuppuswamy, A.V. Balasubramaniam, R. Maksimovic, A. Gall, M.D. Craggs, C.J. Mathias, M. Bacon, A. Prochazka, J. Kowalczewski, B.A. Conway, Sujay Galen, C. Catton, D.B. Allan, A. Curt, B. Wirth, H.J. van Hedel

    Research output: Contribution to journalArticle

    34 Citations (Scopus)

    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.
    LanguageEnglish
    Pages343-357
    Number of pages15
    JournalBrain Research Bulletin
    Volume84
    Issue number4-5
    DOIs
    Publication statusPublished - 10 Mar 2011

    Fingerprint

    Spinal Cord Injuries
    Hand
    Video Games
    Spinal Injuries
    Aptitude
    Transcranial Magnetic Stimulation
    Motor Cortex
    Robotics
    Hand Strength
    Therapeutics
    Upper Extremity
    Electric Stimulation
    Walking
    Regeneration
    Lower Extremity
    Arm
    Rehabilitation
    Outcome Assessment (Health Care)
    Exercise
    Weights and Measures

    Keywords

    • spinal cord injury
    • brain
    • physiology
    • axonal regeneration

    Cite this

    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, Sujay ; Catton, C. ; Allan, D.B. ; Curt, A. ; Wirth, B. ; van Hedel, H.J. / Development of quantitative and sensitive assessments of physiological and functional outcome during recovery from spinal cord injury : a clinical initiative. In: Brain Research Bulletin. 2011 ; Vol. 84, No. 4-5. pp. 343-357.
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    Ellaway, PH, Kuppuswamy, A, Balasubramaniam, AV, Maksimovic, R, Gall, A, Craggs, MD, Mathias, CJ, Bacon, M, Prochazka, A, Kowalczewski, J, Conway, BA, Galen, S, Catton, C, Allan, DB, Curt, A, Wirth, B & van Hedel, HJ 2011, 'Development of quantitative and sensitive assessments of physiological and functional outcome during recovery from spinal cord injury: a clinical initiative' Brain Research Bulletin, vol. 84, no. 4-5, pp. 343-357. https://doi.org/10.1016/j.brainresbull.2010.08.007

    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, Sujay; Catton, C.; Allan, D.B.; Curt, A.; Wirth, B.; van Hedel, H.J.

    In: Brain Research Bulletin, Vol. 84, No. 4-5, 10.03.2011, p. 343-357.

    Research output: Contribution to journalArticle

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