Functional stimulation system for rehabilitation of gait and driving neural plasticity after spinal cord injury

Sensorimotor rehabilitation is so far the most extended and powerful intervention applied to enhance functional recovery to people with spinal cord injuries. Although the activity dependent plasticity mechanisms induced in the spinal networks remain unknown, extensive studies in humans and animal models have revealed the importance that the intrinsic variables of each rehabilitation regime have for the obtaining the highest degree of recovery. Nevertheless, since the gain achieved is incomplete, compensatory, or synergistic interventions which can increase the efficiency of patient’s sensorimotor outcome are being under intensive research. In this line, the present study is aimed to evaluate the locomotor recovery of spinal cord injured rats receiving bilateral alternate functional electrical stimulation of hindlimb extensor muscles while being awake but not performing any exercise, compared to animals enrolled in daily treadmill locomotor training. Our results indicate that both experimental groups showed improved sensory and motor function after 2-month treatment compared to injured but not treated animals. However, no different behavioral nor electrophysiological differences were found between the two groups subjected to rehabilitation protocols. We conclude the feasibility of FES to promote spinal plasticity and motor recovery and its utility to substitute or add to conventional task specific rehabilitation.