Background: Locomotion is a basic motor act which is essential for the survival of humans. The basic muscle synergies which are responsible for body propulsion are generated by the neurons in spinal cord collectively known as Central Pattern Generator for Locomotion. Spinal Cord is the major conduit for the transmission of information between brain and the rest of the body. Injury to the spinal cord is the insult to the neural elements of the spinal canal from foramen magnum to cauda equina. SCIs are heterogeneous in casualty, severity and location of injury but locomotion is the ultimate goal for the post-SCI survivors. In order for locomotion to occur, a complex CPG center of locomotion activation is required. Exercise based approach is the cornerstone in the treatment and management of individuals with SCI. Objective: To study the existing evidence on the effectiveness of Exercise-based approaches to activate Central Pattern Generator in Spinal Cord Injury Survivors with a focus on randomized controlled trials and cross over trials studies. Methodology: Literature published in English language. Original publications including RCTs and cross over trials published in peer-reviewed journals focused on traumatic or non-traumatic spinal cord injury published from 2014 to 2022. A key literature search adopted, for a more targeted search the following terms were used: effect of exercise, task-based approaches, body weight supported treadmill training, over ground training, balance and coordination training on the activation. Search Strategy: Database used were PubMed, Cochrane, Scopus, EMBASE, CINAHL and Medline. Results: Assessment of Risk of Bias was done using PeDro analysis. Eleven studies met the inclusion criteria out of 300 studies searched. Discussion: Exercise based approaches are highly essential and integrated part of the rehabilitation of spinal cord injury survivors. It has been concluded that activity-based therapies are highly effective but under-utilized by the rehabilitation specialists.
| Published in | International Journal of Neurologic Physical Therapy (Volume 10, Issue 1) |
| DOI | 10.11648/j.ijnpt.20241001.12 |
| Page(s) | 8-15 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Activity-Based Therapy (ABT), Central Pattern Generator (CPG), PubMed, PeDro
| [1] | Jazayeri, Seyed Behnam et al. (2023) 'Incidence of traumatic spinal cord injury worldwide: A systematic review, data integration, and update,' World Neurosurgery: X, 18, p. 100171. |
| [2] | Ding, W. et al. (2022) 'Spinal cord Injury: The Global Incidence, Prevalence, and Disability from the Global Burden of Disease Study 2019,' Spine, 47(21), pp. 1532–1540. |
| [3] | Amidei, C. B. et al. (2022) 'Epidemiology of traumatic spinal cord injury: a large population-based study,' Spinal Cord, 60(9), pp. 812–819. |
| [4] | Wulf, M. J. and Tom, V. J. (2023) 'Consequences of spinal cord injury on the sympathetic nervous system,' Frontiers in Cellular Neuroscience, 17. |
| [5] | Jones, M. L., Evans, N., Tefertiller, C., Backus, D., Sweatman, M., Tansey, K. and Morrison, S. (2014). Activity-Based Therapy for Recovery of Walking in Individuals with Chronic Spinal Cord Injury: Results from a Randomized Clinical Trial. Archives of Physical Medicine and Rehabilitation, [online] 95(12), pp. 2239-2246. e2. |
| [6] | Hubscher, C. H. et al. (2021) 'Effect of different forms of Activity-Based recovery training on bladder, bowel, and sexual function after spinal cord injury,' Archives of Physical Medicine and Rehabilitation, 102(5), pp. 865–873. |
| [7] | Cheung, L. et al. (2021) 'Activity-based therapy in the community for individuals living with spinal cord injury or disease: qualitative interviews with clinicians,' Disability and Rehabilitation, 44(17), pp. 4821–4830. |
| [8] | Liao, F. et al. (2023) 'Application of Multiscale Sample Entropy in Assessing Effects of Exercise Training on Skin Blood Flow Oscillations in People with Spinal Cord Injury,' Entropy, 25(4), p. 690. |
| [9] | Dromerick, A. W., Lum, P. S. and Hidler, J. (2006) 'Activity-based therapies,' NeuroRx, 3(4), pp. 428–438. |
| [10] | De Oliveira, C. Q. et al. (2019) 'Activity-Based therapy in a community setting for independence, mobility, and sitting balance for people with spinal cord injuries,' Journal of Central Nervous System Disease, 11, p. 117957351984162. |
| [11] | Alcántar-Garibay, O. V., Incontri–Abraham, D. and Ibarra, A. (2022) 'Spinal cord injury-induced cognitive impairment: a narrative review,' Neural Regeneration Research, 17(12), p. 2649. |
| [12] | Anjum, A. et al. (2020) 'Spinal cord injury: pathophysiology, multimolecular interactions, and underlying recovery mechanisms,' International Journal of Molecular Sciences, 21(20), p. 7533. |
| [13] | Balbinot, G. et al. (2023) 'Segmental motor recovery after cervical spinal cord injury relates to density and integrity of corticospinal tract projections,' Nature Communications, 14(1). |
| [14] | Bedi, P. K., Arumugam, N. and Chhabra, H. S. (2018) 'Effectiveness of Activity-Based Therapy in Comparison with Surface Spinal Stimulation in People with Traumatic Incomplete Spinal Cord Injury for Activation of Central Pattern Generator for Locomotion: Study Protocol for a 24-Week Randomized Controlled Trial,' Asian Spine Journal, 12(3), pp. 503–510. |
| [15] | Cao, Y. and Krause, J. S. (2020) 'Estimation of indirect costs based on employment and earnings changes after spinal cord injury: an observational study,' Spinal Cord, 58(8), pp. 908–913. |
| [16] | Dai, C.-Q., Gao, M., Lin, X., Xue, B.-J., Liang, Y., Xu, M., Wu, X., Cheng, G., Xu, H., Zhao, C., Yuan, H. and Sun, X. (2023). Primary motor hand area corticospinal excitability indicates overall functional recovery after spinal cord injury. Frontiers in Neurology, 14. |
| [17] | Dhall, S. S. et al. (2017) 'Motor evoked potentials correlate with magnetic resonance imaging and early recovery after acute spinal cord injury,' Neurosurgery, 82(6), pp. 870 876. |
| [18] | Ditunno, J. F. et al. (2013) 'The Walking Index for Spinal Cord Injury (WISCI/WISCI II): nature, metric properties, use and misuse,' Spinal Cord, 51(5), pp. 346–355. |
| [19] | Dorey, T. W. et al. (2023) 'Effects of exercise on autonomic cardiovascular control in individuals with chronic, motor-complete spinal cord injury: an exploratory randomised clinical trial,' Research Square (Research Square) [Preprint]. |
| [20] | Edwards, D. J., Forrest, G., Cortes, M., Weightman, M. M., Sadowsky, C., Chang, S.-H., Furman, K., Bialek, A., Prokup, S., Carlow, J., VanHiel, L., Kemp, L., Musick, D., Campo, M. and Jayaraman, A. (2022). Walking improvement in chronic incomplete spinal cord injury with exoskeleton robotic training (WISE): a randomized controlled trial. Spinal Cord. |
| [21] | Flett, S., Garcia, J. L. and Cowley, K. C. (2022) 'Spinal electrical stimulation to improve sympathetic autonomic functions needed for movement and exercise after spinal cord injury: a scoping clinical review,' Journal of Neurophysiology, 128(3), pp. 649–670. |
| [22] | Guertin, P. A. (2013) 'Central Pattern generator for locomotion: anatomical, physiological, and pathophysiological considerations,' Frontiers in Neurology, 3. |
| [23] | Hagen, E. M. (2015) 'Acute complications of spinal cord injuries,' World Journal of Orthopedics, 6(1), p. 17. |
| [24] | Hu, Y. et al. (2023) 'Epidemiological features of traumatic spinal cord injury in China: A systematic review and meta-analysis,' Frontiers in Neurology, 14. |
| [25] | Jo, H. J. et al. (2023) 'Multisite Hebbian Plasticity Restores Function in Humans with Spinal Cord Injury,' Annals of Neurology, 93(6), pp. 1198–1213. |
| [26] | Maggio, M. G. et al. (2023) 'Do Individuals with Spinal Cord Injury Benefit from Semi-Immersive Virtual Reality Cognitive Training? Preliminary Results from an Exploratory Study on an Underestimated Problem,' Brain Sciences, 13(6), p. 945. |
| [27] | Martin, J. H. (2022) 'Neuroplasticity of spinal cord injury and repair,' in Handbook of Clinical Neurology, pp. 317–330. |
| [28] | Mulcahey, M. J. et al. (2017) 'Despite limitations in content range, the SCIM-III is reproducible and a valid indicator of physical function in youths with spinal cord injury and dysfunction,' Spinal Cord, 56(4), pp. 332–340. |
| [29] | Piira, A., Lannem, A., Sørensen, M., Glott, T., Knutsen, R., Jørgensen, L., Gjesdal, K., Hjeltnes, N. and Knutsen, S. (2019). Robot-assisted locomotor training did not improve walking function in patients with chronic incomplete spinal cord injury: A randomized clinical trial. Journal of Rehabilitation Medicine, 51(5), pp. 385–389. |
| [30] | Senthilvelkumar, T., Magimairaj, H., Fletcher, J., Tharion, G. and George, J. (2014). Comparison of body weight-supported treadmill training versus body weight-supported overground training in people with incomplete tetraplegia: a pilot randomized trial. Clinical Rehabilitation, 29(1), pp. 42–49. |
| [31] | Shulga, A. et al. (2021) 'A novel paired associative stimulation protocol with a high–frequency peripheral component: A review on results in spinal cord injury rehabilitation,' European Journal of Neuroscience, 53(9), pp. 3242–3257. |
| [32] | Steuer, I. and Guertin, P. A. (2019) 'Central pattern generators in the brainstem and spinal cord: an overview of basic principles, similarities and differences,' Reviews in the Neurosciences, 30(2), pp. 107–164. |
| [33] | Young, H.-J., Mehta, T., Kim, Y., Padalabalanarayanan, S., Chiu, C.-Y., Rimmer, J. H. and Thirumalai, M. (2021). The Spinal Cord Injury Program in Exercise (SCIPE) study: study protocol for a randomized controlled trial evaluating tele-exercise programs for people with spinal cord injury. Trials, 22(1). |
APA Style
Kaur, S., Arumugam, N., Chhabra, H. S. (2024). A Systematic Review: Exercise Based Approaches to Activate Central Pattern Generator in Spinal Cord Injury Survivors . International Journal of Neurologic Physical Therapy, 10(1), 8-15. https://doi.org/10.11648/j.ijnpt.20241001.12
ACS Style
Kaur, S.; Arumugam, N.; Chhabra, H. S. A Systematic Review: Exercise Based Approaches to Activate Central Pattern Generator in Spinal Cord Injury Survivors . Int. J. Neurol. Phys. Ther. 2024, 10(1), 8-15. doi: 10.11648/j.ijnpt.20241001.12
AMA Style
Kaur S, Arumugam N, Chhabra HS. A Systematic Review: Exercise Based Approaches to Activate Central Pattern Generator in Spinal Cord Injury Survivors . Int J Neurol Phys Ther. 2024;10(1):8-15. doi: 10.11648/j.ijnpt.20241001.12
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Download@article{10.11648/j.ijnpt.20241001.12,
author = {Sharanjeet Kaur and Narkeesh Arumugam and Harvinder Singh Chhabra},
title = {A Systematic Review: Exercise Based Approaches to Activate Central Pattern Generator in Spinal Cord Injury Survivors
},
journal = {International Journal of Neurologic Physical Therapy},
volume = {10},
number = {1},
pages = {8-15},
doi = {10.11648/j.ijnpt.20241001.12},
url = {https://doi.org/10.11648/j.ijnpt.20241001.12},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijnpt.20241001.12},
abstract = {Background: Locomotion is a basic motor act which is essential for the survival of humans. The basic muscle synergies which are responsible for body propulsion are generated by the neurons in spinal cord collectively known as Central Pattern Generator for Locomotion. Spinal Cord is the major conduit for the transmission of information between brain and the rest of the body. Injury to the spinal cord is the insult to the neural elements of the spinal canal from foramen magnum to cauda equina. SCIs are heterogeneous in casualty, severity and location of injury but locomotion is the ultimate goal for the post-SCI survivors. In order for locomotion to occur, a complex CPG center of locomotion activation is required. Exercise based approach is the cornerstone in the treatment and management of individuals with SCI. Objective: To study the existing evidence on the effectiveness of Exercise-based approaches to activate Central Pattern Generator in Spinal Cord Injury Survivors with a focus on randomized controlled trials and cross over trials studies. Methodology: Literature published in English language. Original publications including RCTs and cross over trials published in peer-reviewed journals focused on traumatic or non-traumatic spinal cord injury published from 2014 to 2022. A key literature search adopted, for a more targeted search the following terms were used: effect of exercise, task-based approaches, body weight supported treadmill training, over ground training, balance and coordination training on the activation. Search Strategy: Database used were PubMed, Cochrane, Scopus, EMBASE, CINAHL and Medline. Results: Assessment of Risk of Bias was done using PeDro analysis. Eleven studies met the inclusion criteria out of 300 studies searched. Discussion: Exercise based approaches are highly essential and integrated part of the rehabilitation of spinal cord injury survivors. It has been concluded that activity-based therapies are highly effective but under-utilized by the rehabilitation specialists.
},
year = {2024}
}
TY - JOUR T1 - A Systematic Review: Exercise Based Approaches to Activate Central Pattern Generator in Spinal Cord Injury Survivors AU - Sharanjeet Kaur AU - Narkeesh Arumugam AU - Harvinder Singh Chhabra Y1 - 2024/04/02 PY - 2024 N1 - https://doi.org/10.11648/j.ijnpt.20241001.12 DO - 10.11648/j.ijnpt.20241001.12 T2 - International Journal of Neurologic Physical Therapy JF - International Journal of Neurologic Physical Therapy JO - International Journal of Neurologic Physical Therapy SP - 8 EP - 15 PB - Science Publishing Group SN - 2575-1778 UR - https://doi.org/10.11648/j.ijnpt.20241001.12 AB - Background: Locomotion is a basic motor act which is essential for the survival of humans. The basic muscle synergies which are responsible for body propulsion are generated by the neurons in spinal cord collectively known as Central Pattern Generator for Locomotion. Spinal Cord is the major conduit for the transmission of information between brain and the rest of the body. Injury to the spinal cord is the insult to the neural elements of the spinal canal from foramen magnum to cauda equina. SCIs are heterogeneous in casualty, severity and location of injury but locomotion is the ultimate goal for the post-SCI survivors. In order for locomotion to occur, a complex CPG center of locomotion activation is required. Exercise based approach is the cornerstone in the treatment and management of individuals with SCI. Objective: To study the existing evidence on the effectiveness of Exercise-based approaches to activate Central Pattern Generator in Spinal Cord Injury Survivors with a focus on randomized controlled trials and cross over trials studies. Methodology: Literature published in English language. Original publications including RCTs and cross over trials published in peer-reviewed journals focused on traumatic or non-traumatic spinal cord injury published from 2014 to 2022. A key literature search adopted, for a more targeted search the following terms were used: effect of exercise, task-based approaches, body weight supported treadmill training, over ground training, balance and coordination training on the activation. Search Strategy: Database used were PubMed, Cochrane, Scopus, EMBASE, CINAHL and Medline. Results: Assessment of Risk of Bias was done using PeDro analysis. Eleven studies met the inclusion criteria out of 300 studies searched. Discussion: Exercise based approaches are highly essential and integrated part of the rehabilitation of spinal cord injury survivors. It has been concluded that activity-based therapies are highly effective but under-utilized by the rehabilitation specialists. VL - 10 IS - 1 ER -
Department of Physiotherapy, Punjabi University, Patiala, India
Department of Physiotherapy, Punjabi University, Patiala, India
Spinal Surgeon, Shri Balaji Action Spine Institute, New Delhi, India
