Promoting Gait Recovery and Limiting Neuropathic Pain After Spinal Cord Injury.

TitlePromoting Gait Recovery and Limiting Neuropathic Pain After Spinal Cord Injury.
Publication TypeJournal Article
Year of Publication2017
AuteursMercier, C, Roosink, M, Bouffard, J, Bouyer, LJ
JournalNeurorehabil Neural Repair
Volume31
Issue4
Pagination315-322
Date Published2017 Apr
ISSN1552-6844
KeywordsAnimals, Gait, Humans, Neuralgia, Physical Therapy Modalities, Recovery of Function, Spinal Cord Injuries
Abstract

Most persons living with a spinal cord injury experience neuropathic pain in the months following their lesion, at the moment where they receive intensive gait rehabilitation. Based on studies using animal models, it has been proposed that central sensitization in nociceptive pathways (maladaptive plasticity) and plasticity related to motor learning (adaptive plasticity) share common neural mechanisms and compete with each other. This article aims to address the discrepancy between the growing body of basic science literature supporting this hypothesis and the general belief in rehabilitation research that pain and gait rehabilitation represent two independent problems. First, the main findings from basic research showing interactions between nociception and learning in the spinal cord will be summarized, focusing both on evidence demonstrating the impact of nociception on motor learning and of motor learning on central sensitization. Then, the generalizability of these findings in animal models to humans will be discussed. Finally, the way potential interactions between nociception and motor learning are currently taken into account in clinical research in patients with spinal cord injury will be presented. To conclude, recommendations will be proposed to better integrate findings from basic research into future clinical research in persons with spinal cord injury.

DOI10.1177/1545968316680491
Alternate JournalNeurorehabil Neural Repair
PubMed ID27913797
PubMed Central IDPMC5405804