Bandres Maria F, Gomes Jefferson L, Moreno Romero Gerson N, Twyman Avery R, McPherson Jacob Graves
Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, United States.
Program in Physical Therapy, Washington University School of Medicine in St. Louis, St. Louis, MO, United States.
Front Rehabil Sci. 2023 Apr 19;4:1135593. doi: 10.3389/fresc.2023.1135593. eCollection 2023.
Spinal cord injury results in multiple, simultaneous sensorimotor deficits. These include, but are not limited to, full or partial paralysis of muscles below the lesion, muscle spasms, spasticity, and neuropathic pain. Bowel, bladder, and sexual dysfunction are also prevalent. Yet, the majority of emerging spinal stimulation-based therapies focus on a single issue: locomotor rehabilitation. Despite the enormous potential of these translational advances to transform the lives of people living with spinal cord injury, meaningful recovery in other domains deemed critical priorities remains lacking. Here, we highlight the importance of considering the diverse patterns of neural transmission that underlie clinically similar presentations when developing spinal stimulation-based therapies. We also motivate advancement of multi-modal rehabilitation paradigms, which leverage the dense interconnectivity of sensorimotor spinal networks and the unique ability of electrical stimulation to modulate these networks to facilitate and guide simultaneous rehabilitation across domains.
脊髓损伤会导致多种同时出现的感觉运动功能障碍。这些功能障碍包括但不限于损伤部位以下肌肉的完全或部分瘫痪、肌肉痉挛、强直以及神经性疼痛。肠道、膀胱和性功能障碍也很常见。然而，大多数新兴的基于脊髓刺激的疗法都只关注一个问题：运动功能康复。尽管这些转化医学进展具有巨大潜力，可以改变脊髓损伤患者的生活，但在其他被视为关键优先事项的领域仍缺乏有意义的恢复。在此，我们强调在开发基于脊髓刺激的疗法时，考虑临床相似表现背后多样神经传递模式的重要性。我们还推动多模式康复范式的发展，这种范式利用感觉运动脊髓网络的密集互连性以及电刺激调节这些网络的独特能力，以促进和指导跨领域的同步康复。
