Neuromodulation For Restoration Of Spinal Autonomic Functions That Increase Exercise Capacity After Spinal Cord Injury
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| Author | : Sarah Flett |
| Publisher | : |
| Total Pages | : 0 |
| Release | : 2021 |
| Genre | : |
| ISBN | : |
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.
| Author | : Enrico Rejc |
| Publisher | : Frontiers Media SA |
| Total Pages | : 166 |
| Release | : 2022-02-14 |
| Genre | : Science |
| ISBN | : 2889743918 |
| Author | : Soshi Samejima |
| Publisher | : |
| Total Pages | : 186 |
| Release | : 2020 |
| Genre | : |
| ISBN | : |
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.
| Author | : David J. Reinkensmeyer |
| Publisher | : Springer Nature |
| Total Pages | : 771 |
| Release | : 2022-11-15 |
| Genre | : Medical |
| ISBN | : 3031089952 |
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.
| Author | : Hongyun Huang |
| Publisher | : Nova Science Publishers |
| Total Pages | : 0 |
| Release | : 2015 |
| Genre | : Nervous system |
| ISBN | : 9781634636001 |
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.
| Author | : Susan J. Harkema |
| Publisher | : |
| Total Pages | : 200 |
| Release | : 2011 |
| Genre | : Medical |
| ISBN | : 0195342089 |
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.
| Author | : Alojz Kralj |
| Publisher | : Routledge |
| Total Pages | : 208 |
| Release | : 2022-01-27 |
| Genre | : Medical |
| ISBN | : 1351446843 |
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.
| Author | : Naranjan S. Dhalla |
| Publisher | : Lippincott Williams & Wilkins |
| Total Pages | : 570 |
| Release | : 1995 |
| Genre | : Medical |
| ISBN | : |
| Author | : Firas H. Kobeissy |
| Publisher | : CRC Press |
| Total Pages | : 718 |
| Release | : 2015-02-25 |
| Genre | : Medical |
| ISBN | : 1466565993 |
With the contribution from more than one hundred CNS neurotrauma experts, this book provides a comprehensive and up-to-date account on the latest developments in the area of neurotrauma including biomarker studies, experimental models, diagnostic methods, and neurotherapeutic intervention strategies in brain injury research. It discusses neurotrauma mechanisms, biomarker discovery, and neurocognitive and neurobehavioral deficits. Also included are medical interventions and recent neurotherapeutics used in the area of brain injury that have been translated to the area of rehabilitation research. In addition, a section is devoted to models of milder CNS injury, including sports injuries.
| Author | : |
| Publisher | : Academic Press |
| Total Pages | : 1089 |
| Release | : 2009-05-05 |
| Genre | : Science |
| ISBN | : 0080921396 |
Neuromodulation will be the first comprehensive and in-depth reference textbook covering all aspects of the rapidly growing field of neuromodulation. This book provides a complete discussion of the fundamental principles of neuromodulation and therapies applied to the brain, spinal cord, peripheral nerves, autonomic nerves and various organs. The textbook is highly structured and organized into overarching sections that cover chronic pain, movement disorders, psychiatric disorders, epilepsy, functional electrical stimulation, cardiac, gastrointestinal, genitourinary and organ neuromodulation. The fundamental principles of electricity and infusion, neural tissue interface, biomedical engineering, neuromodulation devices, basic science, neuroanatomy, neurophysiology, imaging and mechanisms are emphasized. In addition to providing details pertaining to the state-of-the-art current practice, innovative and emerging applications are discussed in specific chapters. Finally, the textbook provides specific chapters focusing on the technical aspects of the various neuromodulation procedures as well as technical specifications of various implantable devices. All of the contributors to Neuromodulation represent leading experts in the field. The editors are internationally renowned in their respective fields of neuromodulation, pain management, functional neurosurgery and biomedical engineering. Neuromodulation will be the first and foremost authoritative text on neuromodulation therapies and will establish the gold standard that defines the field for years to come. Key Features The first comprehensive reference on the emerging field of Neuromodulation Editors and authors include all leading figures in the field, and the leaders of the International Neuromodulation Society Over 90 chapters on topics ranging from a layout of the fundamentals (e.g. neuroanatomy, plasticity, bioelectrical effects, infusion therapies), solutions for the biomedical engineering challenges (e.g. materials, how to preserve normal function etc.), to a rundown of the existing applications and their future promise Over 1200 pages in splendid full color, richly illustrated Important areas of application include: control of chronic pain delivery of drugs to the nervous system via implanted devices control of epilepsy, Parkinson, etc. functional restoration, e.g. visual, auditory, restoration after stroke, restoration of motor function after traumatic events stimulation of body organs via neural devices (incl. the heart, abdominal organs, genitourinary organs) overview over newly emerging fields - control of obesity, blood pressure, tinnitus, brain injury, neurodegenerative diseases, brain-machine interfaces
