The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
Neurorehabil Neural Repair. 2012 Sep;26(7):861-9. doi: 10.1177/1545968311433603. Epub 2012 Feb 9.
Impaired walking is a debilitating consequence of spinal cord injury (SCI). This impairment arises, to some degree, from disruption of supraspinal pathways that activate the spinal locomotor central pattern generator (CPG). Evidence in nondisabled (ND) individuals suggests that vibration activates locomotor CPGs, eliciting involuntary step-like behavior.
To compare vibration-elicited step-like behavior in individuals with chronic SCIs with the responses of ND individuals and to assess the influence of locomotor training on these responses.
Participants included 7 individuals with motor-incomplete SCIs (MISCIs) and 6 with motor-complete SCIs (MCSCIs) who were untrained, 6 individuals with MISCIs who underwent locomotor training, and 8 ND individuals. Kinematic and EMG data were collected while vibration was applied to the quadriceps, hamstrings, or tensor fascia latae (TFL) muscles. Consistency and robustness of vibration-elicited responses was determined from hip and knee angle data.
Consistent and reliable step-like behaviors were elicited in individuals with MISCIs and MCSCIs, although responses were not as robust as those in ND individuals. Vibration to the TFL elicited the most robust responses. Consistency and robustness were not influenced by SCI severity or locomotor training but appeared to increase with repeated testing.
These results confirm that vibration elicits step-like behaviors in individuals with SCIs, even those with no voluntary motor function in the legs. Further research is warranted to investigate the use of vibration as an approach to activating the spinal CPGs associated with stepping, perhaps as an adjunct to locomotor training for individuals with SCIs.
行走障碍是脊髓损伤(SCI)的一种使人衰弱的后果。这种损伤在某种程度上是由于激活脊髓运动中枢模式发生器(CPG)的上位通路中断引起的。非残疾(ND)个体的证据表明,振动激活运动 CPG,引起非自愿的类似步行动作。
比较慢性 SCI 个体中振动诱发的类似步行动作与 ND 个体的反应,并评估运动训练对这些反应的影响。
参与者包括 7 名运动不完全性 SCI(MISCI)和 6 名运动完全性 SCI(MCSCI)的未训练者、6 名接受运动训练的 MISCI 个体和 8 名 ND 个体。在振动施加到股四头肌、腘绳肌或阔筋膜张肌时,收集运动学和肌电图数据。从髋部和膝部角度数据确定振动诱发反应的一致性和稳健性。
MISCI 和 MCSCI 个体中诱发了一致且可靠的类似步行动作,尽管反应不如 ND 个体稳健。振动到阔筋膜张肌引起的反应最稳健。一致性和稳健性不受 SCI 严重程度或运动训练的影响,但似乎随着重复测试而增加。
这些结果证实,振动可在 SCI 个体中诱发类似步行动作,即使他们腿部没有自主运动功能。需要进一步研究以调查振动作为激活与踏步相关的脊髓 CPG 的方法的使用,也许可以作为 SCI 个体运动训练的辅助手段。