Training potentiates the efficacy of the adipose-stromal vascular fraction autograft on functional recovery after an acute spinal cord contusion in rats

Spinal cord injuries (SCI) are a major health concern, resulting in substantial functional deficits, including vegetative, motor and sensory impairments around and below the affected area. Despite continuous efforts, current spinal cord repair strategies have proven ineffective. The adipose-derived stromal vascular fraction (SVF) contains cells with trophic, pro-angiogenic, and immunomodulatory effects. Our previous study demonstrated that autologous SVF transplantation did not induce endogenous inflammation in SCI rats 14 days after injury. Additionally, it showed the benefits of autologous SVF transplantation on sensorimotor recovery after SCI in rats. This study aims to show that a combined approach of SVF autograft supplemented by treadmill training can enhance functional recovery after SCI in rats. Male Sprague Dawley rats were categorized into four groups: NaCl (spinal cord contusion with NaCl application) and SVF (spinal cord contusion with SVF autograft), NaCl-T (spinal cord contusion with NaCl application followed by treadmill training), and SVF-T (spinal cord contusion with SVF autograft followed by treadmill training). Sensorimotor recovery was monitored weekly for 12 weeks, with gait, electrophysiological, and histological analyses at the end-point. Results suggest that the combined SVF autograft and treadmill training strategy improves sensorimotor recovery, by restoring the segmental sensorimotor loop and communication between supraspinal and sublesional spinal regions. Histological analyses reveal a significant reduction in lesion volume in treated and trained animals. This study highlights the effectiveness of autologous SVF grafting combined with treadmill training in acute SCI, indicating its potential as a promising therapeutic approach for spinal cord repair following traumatic contusions in humans.