Download or read book Neuromodulation Through Spinal Cord Stimulation for Functional Restoration and Rehabilitation After Cervical Spinal Cord Injury written by Soshi Samejima and published by . This book was released on 2020 with total page 186 pages. Available in PDF, EPUB and Kindle. Book excerpt: Spinal cord injury (SCI) results in permanent neurological deficits. The limited physical function impacts quality of life and socioeconomic engagement. Up to now, we have no effective interventions to restore impaired function. Activity-dependent plasticity holds great promise to promote recovery of motor and autonomic function. Neuromodulation via electrical stimulation of the spinal cord has shown growing evidence of promoting activity-dependent plasticity and functional gains following SCI. First, we review the background information about the burden and recovery process of SCI. We also summarize current advances of pharmacological, cellular, and neuromodulation approaches. Emerging evidence with stimulation technologies demonstrates potential to facilitate neuroplasticity bridging the lesion. In the second part, we demonstrated a cost- and time-efficient experimental tool to assess forelimb function in a rodent model with severe cervical SCI. This novel strategy for the behavior task may accelerate preclinical trials. By using the behavior tasks, in the third part, we present a clinically viable brain-computer spinal interface to reanimate paralyzed forelimb function in rodents with cervical SCI. We demonstrate a stable and computationally efficient local field potential decoder enabling graded forelimb movements via epidural stimulation. Consequently, the brain-controlled epidural stimulation led to functional improvements in freely moving rats with cervical SCI. The closed-loop algorithm was implemented in an implantable size circuit capable of onboard computing, providing a clinically viable strategy to accelerate the translation of brain-computer interfaces to human use. In the fourth part, we investigate the efficacy of transcutaneous spinal stimulation paired with intensive locomotor training in two individuals with cervical SCI. We present the additive effect of transcutaneous spinal stimulation for locomotor recovery with more coordinated movements. Furthermore, we demonstrate the first evidence of transcutaneous spinal stimulation for restoring bowel function. Lastly, we discuss the potential of these neurotechnology approaches. We address the current limitations of scientific understanding and technology to guide future research to restore sensorimotor and autonomic function following cervical SCI.
Download or read book Rehabilitation in Spinal Cord Injuries written by Jacqueline E. Reznik and published by Elsevier Health Sciences. This book was released on 2020-02-01 with total page 518 pages. Available in PDF, EPUB and Kindle. Book excerpt: Specialised chapters about biomechanics, paediatric spinal cord injury and high cervical injuries Insight into the lived experience of individuals with a spinal cord injury Documentation of the patient journey from injury to total rehabilitation Practical information on mobility devices and returning to driving Appendix of common assessments for spinal cord injuries Includes an eBook with purchase of the print book
Download or read book Transcutaneous Spinal Cord Stimulation for Restoration of Upper Extremity Function After Spinal Cord Injury written by Fatma Inanici and published by . This book was released on 2019 with total page 98 pages. Available in PDF, EPUB and Kindle. Book excerpt: Spinal cord injury is currently incurable. Standard of care after spinal cord injury focuses on prevention of the secondary complications and maximizing residual function. The most common site of injury is the cervical level that results in tetraplegia. Incomplete cervical injury is the most frequent neurological category. Loss of motor control and sensory function in the upper extremity is a particularly devastating aspect of cervical injuries that impairs the ability to perform activities of daily living. Restoration of hand and arm function is consistently rated as the highest treatment priority among people with tetraplegia due to cervical spinal cord injury, 5-fold higher than any other function included in the surveys. Nevertheless, current approaches to improve hand and arm function are largely ineffective. Electrical spinal cord stimulation, however, is one of the emerging neuromodulation strategies to restore motor function. The aims of this dissertation are to (1) review the applications of therapeutic electrical spinal cord stimulation after spinal cord injury, (2) determine improvements in hand and arm function resulting from non-invasive electrical cervical spinal cord stimulation, and (3) quantify long-term benefits that may persist beyond the stimulation. Therapeutic potential of transcutaneous spinal cord stimulation is evaluated in a prospective, open-label, two arm cross-over study. Intervention arms consist of intensive upper limb functional task training alone and transcutaneous electrical cervical spinal cord stimulation combined with training. The Graded Redefined Assessment of Strength, Sensation and Prehension is used as the primary outcome measure. Improvements achieved by training alone are compared to those obtained when transcutaneous spinal cord stimulation is paired with training. The findings demonstrate that transcutaneous cervical spinal cord stimulation has augmentative effect on restoration of hand and arm function. Additionally, gains are maintained up to six months without stimulation or training, suggesting that electrical stimulation can promote neuroplasticity. This dissertation provides evidence that transcutaneous spinal cord stimulation is a highly promising intervention for recovery of upper extremity function after cervical spinal cord injury, with the significant advantage of not requiring surgery.
Download or read book Advances in Spinal Cord Epidural Stimulation for Motor and Autonomic Functions Recovery After Severe Spinal Cord Injury written by Enrico Rejc and published by Frontiers Media SA. This book was released on 2022-02-14 with total page 166 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Spinal Cord Injury written by Martha Somers and published by F.A. Davis. This book was released on 2024-03-18 with total page 1067 pages. Available in PDF, EPUB and Kindle. Book excerpt: A comprehensive approach to complex challenges Here’s the foundational knowledge, skills, and understanding physical therapists need to develop and implement rehabilitation programs for persons living with spinal cord injuries. From coverage of pathology and the pathological repercussions through medical and rehabilitative management to patient and family education, students will be prepared to be effective members of the rehabilitation team. They’ll also understand the importance of psychosocial adaptation and develop insights into their roles in the process.
Download or read book Spinal Cord Injury written by Martha Freeman Somers and published by . This book was released on 2001 with total page 488 pages. Available in PDF, EPUB and Kindle. Book excerpt: This unique reference is an in-depth examination of the central role of the physical therapist in rehabilitation following spinal cord injury. This book encompasses all of the elements involved in a successful rehabilitation program. It includes a basic understanding of spinal cord injuries and issues relevant to disability, as well as knowledge of the physical skills involved in functional activities and the therapeutic strategies for acquiring these skills. It also presents an approach to the cord-injured person that promotes self-respect and encourages autonomy.Comprehensive information equips readers with a broad foundation of knowledge including topics relevant to spinal cord injury, its pathological repercussions, and medical and rehabilitative management in preparation for program planning, patient and family education, and effective participation as a member of a rehabilitation team. Problem-solving exercises prepare readers for problem-solving in a clinical setting with gray-boxed problems in each chapter that pose clinical questions. Appendix A presents solutions to problems. Abundant illustrations clarify the information presented in the text.An excellent reference for physical therapists.
Download or read book Neuromodulation for Restoration of Spinal Autonomic Functions that Increase Exercise Capacity After Spinal Cord Injury written by Sarah Flett and published by . This book was released on 2021 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Spinal cord injury results in varying degrees of motor and autonomic dysfunction. Cardiovascular and metabolic diseases are much more prevalent with an earlier onset in persons with spinal cord injury compared to the general population. Physical activity is widely accepted method for maintaining appropriate body weight, composition and overall health. Unfortunately, those living with a cervical or high thoracic spinal cord injury experience mild to severe dysautonomia, limiting their exercise performance and subsequent health benefits. Electrical spinal cord stimulation has been a therapeutic strategy investigated in recent years and has demonstrated beneficial effects on motor function as well as autonomic functions related to bladder, bowel and sexual function. Within the last 15 years, spinal stimulation studies aimed at improving motor function began to include anecdotal reports of improved autonomic functions, such cardiovascular control, metabolism, and exercise performance. This area of research is relatively new, and the neural mechanisms mediating these positive effects and the optimal parameters and stimulus locations have yet to be elucidated. We therefore performed a systematic scoping review to identify what has been reported about the effects of spinal cord stimulation on autonomic functions related to exercise outcomes to help identify knowledge gaps. A total of 1815 unique records were screened for eligibility following an electronic database search of Medline, EMBASE, Scopus, CINAHL and SportDiscus. Based on our inclusion criteria, 21 studies were included in this review. Of these 21 articles, 9 were transcutaneous stimulation studies and 12 were epidural stimulation studies. Improvements in blood pressure regulation, exercise output, thermoregulation, and body composition were reported in multiple studies. However, stimulation locations and parameters were highly variable and the number of participants relatively small. Therefore, further pre-clinical mechanism-based research and studies systematically testing different stimulus locations and parameters with larger numbers of participants are necessary to establish optimal stimulation interventions to improve exercise related autonomic functions.
Download or read book Neurorehabilitation Technology written by David J. Reinkensmeyer and published by Springer Nature. This book was released on 2022-11-15 with total page 771 pages. Available in PDF, EPUB and Kindle. Book excerpt: This revised, updated, and substantially expanded third edition provides an accessible, practical overview of major areas of research, technical development and clinical application in the field of neurorehabilitation movement therapy. The initial section provides the basic framework and a rationale for technology application in movement therapy by summarizing recent findings in neuroplasticity and motor learning. The following section provides a detailed overview of the movement physiology of various neurologic conditions, illustrating how this knowledge has been used to design various neurorehabilitation technologies. The third section then explains the principles of human-machine interaction for movement rehabilitation. The fourth section provides an overview of assessment technology and predictive modeling in neurorehabilitation. The fifth section provides a survey of technological approaches to neurorehabilitation, including spinal cord stimulation, functional electrical stimulation, virtual reality, wearable sensing, brain computer interfaces, mobile technologies, and telerehabilitation. The final two sections examine in greater detail the ongoing revolution in robotic therapy for upper extremity movement and walking, respectively. The promises and limitations of these technologies in neurorehabilitation are discussed, including an Epilogue which debates the impact and utility of robotics for neurorehabilitation. Throughout the book the chapters provide detailed practical information on state-of-the-art clinical applications of these devices following stroke, spinal cord injury, and other neurologic disorders and future developments in the field. The text is illustrated throughout with photographs and schematic diagrams which serve to clarify the information for the reader. Neurorehabilitation Technology, Third Edition is a valuable resource for neurologists, biomedical engineers, roboticists, rehabilitation specialists, physiotherapists, occupational therapists and those training in these fields. Chapter “Spinal Cord Stimulation to Enable Leg Motor Control and Walking in People with Spinal Cord Injury is available open access under a Creative Commons Attribution 4.0 International License via link.springer.com.
Download or read book Neurorestoratology written by Hongyun Huang and published by Nova Science Publishers. This book was released on 2015 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Neurorestoratology is one of the most important disciplines in modern medicine and is also the most important discipline in neuroscience. Its core aim is to restore, promote and maintain the integrity of impaired or lost neuronal functions and/or structures by using novel cell-based comprehensive neurorestorative strategies. This book is the first and a unique one that systematically expounds the main aspects of neurorestoratology, which includes three sections with 22 chapters in two volumes. It systematically elaborates CNS neurorestorable theory and neurorestorative mechanisms. It firstly comprehends the Neurorestorative Process as a whole and Neurorestorative law. It fully describes all neurorestorative strategies and their continuing clinical progresses and achievements, especially the cell-based comprehensive neurorestorative strategies.
Download or read book Utilizing Neuromodulation of the Spinal Cord to Assess and Modulate Aberrant Spinal Physiology Below the Lesion Following Severe Upper Motor Neuron Injury written by Lisa Moore and published by . This book was released on 2018 with total page 169 pages. Available in PDF, EPUB and Kindle. Book excerpt: Upper motor neuron injury damages the descending circuits connecting the brain to sensory and motor neurons responsible for sensing and interacting with the world. While spinal cord stimulation is showing extraordinary promise as a novel therapeutic to restore lost motor function following spinal cord injury, we have yet to fully characterize the mechanisms of its action or identify the limits of its therapeutic potential. Towards these ends I conducted a series of three studies which utilized spinal stimulation in novel subject populations to map the cervical spinal cord, identify and modulate aberrant spinal physiology, and enhance upper limb function. In the first study a group of SCI subjects with motor complete lesions, half of which had no measurable hand strength, received transcutaneous stimulation to the cervical spinal cord alone and in combination with the partial serotonergic agonist buspirone. Stimulation but not buspirone significantly improved hand function in subjects with measurable strength prior to the study and maintained hand strength for up to five months following treatment in more functional subjects. In the second study, two subjects who demonstrated improvement with transcutaneous stimulation but failed to maintain it 5 months after treatment, received epidural stimulators. The different properties and performance outcomes of the two forms of stimulation were compared in these severely impaired subjects. Finally in a cohort of rats, epidural stimulation was used to map the cervical spinal cord, track physiological changes in the spinal cord following a severe stroke injury to the motor cortex, and treat observed deficits in reaching success and muscle activity. While 20 Hz stimulation enhanced afferent derived spinal activity, only 1 Hz stimulation resulted in improved reaching success and muscle activity. Together these studies further our understanding, by identifying patient pools most receptive to spinal cord stimulation, characterizing the different properties and functional outcomes of transcutaneous versus epidural stimulation, and illustrating the potential to utilize spinal cord stimulation for other forms of upper motor neuron injury.
Download or read book Translational Research in Traumatic Brain Injury written by Daniel Laskowitz and published by CRC Press. This book was released on 2016-04-21 with total page 388 pages. Available in PDF, EPUB and Kindle. Book excerpt: Traumatic brain injury (TBI) remains a significant source of death and permanent disability, contributing to nearly one-third of all injury related deaths in the United States and exacting a profound personal and economic toll. Despite the increased resources that have recently been brought to bear to improve our understanding of TBI, the developme
Download or read book Locomotor Training written by Susan J. Harkema and published by . This book was released on 2011 with total page 200 pages. Available in PDF, EPUB and Kindle. Book excerpt: Physical rehabilitation for walking recovery after spinal cord injury is undergoing a paradigm shift. Therapy historically has focused on compensation for sensorimotor deficits after SCI using wheelchairs and bracing to achieve mobility. With locomotor training, the aim is to promote recovery via activation of the neuromuscular system below the level of the lesion. What basic scientists have shown us as the potential of the nervous system for plasticity, to learn, even after injury is being translated into a rehabilitation strategy by taking advantage of the intrinsic biology of the central nervous system. While spinal cord injury from basic and clinical perspectives was the gateway for developing locomotor training, its application has been extended to other populations with neurologic dysfunction resulting in loss of walking or walking disability.
Download or read book Towards Cell type Specific Neuromodulation for Spinal Cord Injury Recovery written by George Moukarzel and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Spinal cord injury (SCI) causes life-long neurological impairment, with loss of sensory and motor function distal to the point of injury. There are approximately 300,000 patients living with SCI in the United States, and currently no effective treatment, reducing their quality of life. Amongst other things, proprioception, which has been determined essential for normal locomotion, can be lost with SCI. Epidural Electric Stimulation (EES), that is thought to excite large diameter afferent fibers (LDAF), has been found to improve recovery from spinal cord injury in conjunction with movement rehabilitation in animal models and humans. This represents an exciting new approach to help these patients. However, many open questions remain about how and why EES works. Chief among them are 1) which of the afferent fibers are necessary and sufficient to promote better recovery, and 2) what are the mechanisms of plasticity in the spinal cord that underly improvement. Here, we sought to address the first question by using viral and genetic tools to begin to target specific subsets of LDAF. First, we use a viral vector that preferably transduces only in the large diameter afferent fibers (LDAF) in the Dorsal Root Ganglia (DRG), and then specifically only the proprioceptors within the LDAF, by using a transgenic rat line that expresses Cre recombinase in Parvalbumin, a marker for proprioceptive neurons in the DRG. This approach consists of using the chemogenetic modulator of neuronal activity Designer Receptors Exclusively Activated by Designer Drugs (DREADDs), which are activated by a putatively inert drug, clozapine-N-oxide (CNO), that crosses the blood brain barrier. While we were able to specifically target LDAF with excitatory DREADDs in L3-L5 DRGs in wild type rats, we were unsuccessful at specifically targeting proprioceptors by using the Pvalb-iCre rat line. Additionally, we studied the effect of exciting LDAF on rats with a 200KDyn SCI. CNO withdrawal on the week 7 stage of the recovery was associated with worse ladder performance than the previous and following weeks, as well as worse kinematic behavior of the same week on lower speeds in ankle movement. These results suggest that DREADDs activation is necessary for changes in movement at longer times post injury. It does not rule out that plasticity in neural circuitry has occurred but suggests that plasticity may rely on afferent activation. Finally, we sought to develop new methods to overcome skin motion artifact in rat kinematics by tattooing the knee area under the skin and recording infrared high-speed videos of moving rats which would correct joint calculations beyond just triangulation methods, as well as a novel MATLAB application that can accurately and reliably perform automated H-Reflex measurements, test the stimulating electrodes, and carry out typical instantaneous analyses, which in return allows for faster data collection with reduced human error, and subsequently result in higher research quality.
Download or read book Functional Electrical Stimulation written by Alojz Kralj and published by Routledge. This book was released on 2022-01-27 with total page 208 pages. Available in PDF, EPUB and Kindle. Book excerpt: This reference text covers the fundamental knowledge and principles of functional electrical stimulation (FES) as applied to the spinal cord injured (SCI) patient. The principles of FES application and basic biomechanical issues related to FES in SCI are stressed. The fundamentals regarding patient selection criteria, indication, contraindications, and descriptions of procedures are clearly presented. Also included are the fundamentals and rationale of gait restoration with patient selection, control strategies, and the synthesis of gait sequences with trends in the field. Each chapter contains numerous references to the FES literature for the reader to easily evaluate and extend his knowledge in the area of interest. Biomedical and rehabilitation engineering professionals and researchers for medical doctors, physical therapists, and orthotists will find this publication invaluable.
Download or read book The Failing Heart written by Naranjan S. Dhalla and published by Lippincott Williams & Wilkins. This book was released on 1995 with total page 570 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Stimulated Brain written by Roi Cohen Kadosh and published by Elsevier. This book was released on 2014-06-01 with total page 568 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Stimulated Brain—which garnered an Honorable Mention for Biomedicine & Neuroscience at the 2015 PROSE Awards from the Association of American Publishers—presents the first integration of findings on brain stimulation from different research fields with a primary focus on Transcranial Electrical Stimulation (tES), one of the most frequently used noninvasive stimulation methods. The last decade has witnessed a significant increase in the amount of research exploring how noninvasive brain stimulation can not only modulate but also enhance cognition and brain functions. However, although Transcranial Magnetic Stimulation (TMS) and particularly tES have the potential to become more widely applicable techniques (as they come with none of the risks associated with deep brain stimulation) the reference literature on these neurotechnologies has been sparse. This resource provides a broad survey of current knowledge, and also marks future directions in cognitive and neuro-enhancement. It expands our understanding of basic research findings from animals and humans, including clear translational benefits for applied research and the therapeutic use of noninvasive brain stimulation methods. The book's coverage includes a primer that paves the way to a more advanced knowledge of tES and its physiological basis; current research findings on cognitive and neuro-enhancement in animals and typical and atypical human populations, such as neurological patients; and discussions of future directions, including specific neuroethical issues and pathways for collaboration and entrepreneurialism. The Stimulated Brain is the first book to provide a comprehensive understanding of different aspects of noninvasive brain stimulation that are critical for scientists, clinicians, and those who are interested in “stimulating their minds by exploring this fascinating field of research. Honorable Mention for Biomedicine & Neuroscience in the 2015 PROSE Awards from the Association of American Publishers The only reference on the market to focus on transcranial electrical stimulation (tES) Coverage across technical, historical, and application topics makes this the single, comprehensive resource for researchers and students Edited book with chapters authored by international leaders in the fields of medicine, neuroscience, psychology, and philosophy—providing the broadest, most expert coverage available
Download or read book The Spinal Cord written by Charles Watson and published by Academic Press. This book was released on 2009-11-27 with total page 408 pages. Available in PDF, EPUB and Kindle. Book excerpt: Many hundreds of thousands suffer spinal cord injuries leading to loss of sensation and motor function in the body below the point of injury. Spinal cord research has made some significant strides towards new treatment methods, and is a focus of many laboratories worldwide. In addition, research on the involvement of the spinal cord in pain and the abilities of nervous tissue in the spine to regenerate has increasingly been on the forefront of biomedical research in the past years. The Spinal Cord, a collaboration with the Christopher and Dana Reeve Foundation, is the first comprehensive book on the anatomy of the mammalian spinal cord. Tens of thousands of articles and dozens of books are published on this subject each year, and a great deal of experimental work has been carried out on the rat spinal cord. Despite this, there is no comprehensive and authoritative atlas of the mammalian spinal cord. Almost all of the fine details of spinal cord anatomy must be searched for in journal articles on particular subjects. This book addresses this need by providing both a comprehensive reference on the mammalian spinal cord and a comparative atlas of both rat and mouse spinal cords in one convenient source. The book provides a descriptive survey of the details of mammalian spinal cord anatomy, focusing on the rat with many illustrations from the leading experts in the field and atlases of the rat and the mouse spinal cord. The rat and mouse spinal cord atlas chapters include photographs of Nissl stained transverse sections from each of the spinal cord segments (obtained from a single unfixed spinal cord), detailed diagrams of each of the spinal cord segments pictured, delineating the laminae of Rexed and all other significant neuronal groupings at each level and photographs of additional sections displaying markers such as acetylcholinesterase (AChE), calbindin, calretinin, choline acetlytransferase, neurofilament protein (SMI 32), enkephalin, calcitonin gene-related peptide (CGRP), and neuronal nuclear protein (NeuN). The text provides a detailed account of the anatomy of the mammalian spinal cord and surrounding musculoskeletal elements The major topics addressed are: development of the spinal cord; the gross anatomy of the spinal cord and its meninges; spinal nerves, nerve roots, and dorsal root ganglia; the vertebral column, vertebral joints, and vertebral muscles; blood supply of the spinal cord; cytoarchitecture and chemoarchitecture of the spinal gray matter; musculotopic anatomy of motoneuron groups; tracts connecting the brain and spinal cord; spinospinal pathways; sympathetic and parasympathetic elements in the spinal cord; neuronal groups and pathways that control micturition; the anatomy of spinal cord injury in experimental animals The atlas of the rat and mouse spinal cord has the following features: Photographs of Nissl stained transverse sections from each of 34 spinal segments for the rat and mouse; Detailed diagrams of each of the 34 spinal segments for rat and mouse, delineating the laminae of Rexed and all other significant neuronal groupings at each level. ; Alongside each of the 34 Nissl stained segments, there are additional sections displaying markers such as acetylcholinesterase, calbindin, calretinin, choline acetlytransferase, neurofilament protein (SMI 32), and neuronal nuclear protein (NeuN) All the major motoneuron clusters are identified in relation to the individual muscles or muscle groups they supply
