PMID- 29074997
OWN - NLM
STAT- MEDLINE
DCOM- 20190624
LR  - 20200306
IS  - 2045-2322 (Electronic)
IS  - 2045-2322 (Linking)
VI  - 7
IP  - 1
DP  - 2017 Oct 26
TI  - Motor recovery after activity-based training with spinal cord epidural 
      stimulation in a chronic motor complete paraplegic.
PG  - 13476
LID - 10.1038/s41598-017-14003-w [doi]
LID - 13476
AB  - The prognosis for recovery of motor function in motor complete spinal cord 
      injured (SCI) individuals is poor. Our research team has demonstrated that 
      lumbosacral spinal cord epidural stimulation (scES) and activity-based training 
      can progressively promote the recovery of volitional leg movements and standing 
      in individuals with chronic clinically complete SCI. However, scES was required 
      to perform these motor tasks. Herein, we show the progressive recovery of 
      voluntary leg movement and standing without scES in an individual with chronic, 
      motor complete SCI throughout 3.7 years of activity-based interventions utilizing 
      scES configurations customized for the different motor tasks that were 
      specifically trained (standing, stepping, volitional leg movement). In 
      particular, this report details the ongoing neural adaptations that allowed a 
      functional progression from no volitional muscle activation to a refined, 
      task-specific activation pattern and movement generation during volitional 
      attempts without scES. Similarly, we observed the re-emergence of muscle 
      activation patterns sufficient for standing with independent knee and hip 
      extension. These findings highlight the recovery potential of the human nervous 
      system after chronic clinically motor complete SCI.
FAU - Rejc, Enrico
AU  - Rejc E
AD  - Kentucky Spinal Cord Injury Research Center, University of Louisville, 
      Louisville, Kentucky, USA.
AD  - Department of Neurological Surgery, University of Louisville, Louisville, 
      Kentucky, USA.
FAU - Angeli, Claudia A
AU  - Angeli CA
AD  - Kentucky Spinal Cord Injury Research Center, University of Louisville, 
      Louisville, Kentucky, USA.
AD  - Frazier Rehab Institute, Louisville, Kentucky, USA.
FAU - Atkinson, Darryn
AU  - Atkinson D
AD  - Kentucky Spinal Cord Injury Research Center, University of Louisville, 
      Louisville, Kentucky, USA.
AD  - Department of Neurological Surgery, University of Louisville, Louisville, 
      Kentucky, USA.
FAU - Harkema, Susan J
AU  - Harkema SJ
AD  - Kentucky Spinal Cord Injury Research Center, University of Louisville, 
      Louisville, Kentucky, USA. SusanHarkema@KentuckyOneHealth.org.
AD  - Department of Neurological Surgery, University of Louisville, Louisville, 
      Kentucky, USA. SusanHarkema@KentuckyOneHealth.org.
AD  - Frazier Rehab Institute, Louisville, Kentucky, USA. 
      SusanHarkema@KentuckyOneHealth.org.
LA  - eng
GR  - P30 GM103507/GM/NIGMS NIH HHS/United States
GR  - R01 EB007615/EB/NIBIB NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20171026
PL  - England
TA  - Sci Rep
JT  - Scientific reports
JID - 101563288
SB  - IM
MH  - Adult
MH  - Electrodes, Implanted
MH  - Epidural Space/surgery
MH  - Humans
MH  - Leg/physiopathology
MH  - Male
MH  - *Movement
MH  - Muscle Contraction
MH  - Muscle, Skeletal/innervation/physiopathology
MH  - Neurological Rehabilitation/instrumentation/*methods
MH  - Paraplegia/rehabilitation/*therapy
MH  - Spinal Cord Injuries/rehabilitation/*therapy
MH  - Spinal Cord Stimulation/instrumentation/*methods
PMC - PMC5658385
COIS- The authors declare that they have no competing interests.
EDAT- 2017/10/28 06:00
MHDA- 2019/06/25 06:00
PMCR- 2017/10/26
CRDT- 2017/10/28 06:00
PHST- 2017/07/04 00:00 [received]
PHST- 2017/10/05 00:00 [accepted]
PHST- 2017/10/28 06:00 [entrez]
PHST- 2017/10/28 06:00 [pubmed]
PHST- 2019/06/25 06:00 [medline]
PHST- 2017/10/26 00:00 [pmc-release]
AID - 10.1038/s41598-017-14003-w [pii]
AID - 14003 [pii]
AID - 10.1038/s41598-017-14003-w [doi]
PST - epublish
SO  - Sci Rep. 2017 Oct 26;7(1):13476. doi: 10.1038/s41598-017-14003-w.