Neuroplasticity, the brain's ability to change and form new connections, is key to recovery after spinal cord injury. Repeated sensory feedback training can enhance motor responses by changing synaptic activity in the spinal cord. Studies show that complete spinal cord injuries can sometimes recover limited voluntary control of walking with intensive locomotor training stimulating the spinal cord's pattern generators, demonstrating the potential for neuroplasticity after injury. Strategies like treadmill training, pharmacology, and regenerative techniques aim to further promote plasticity and improve functional recovery.
It provides a brief information about Neuroplasticity to enthusiast willing to know "How we gain daily skills?" and "Changing ability of our brain according to our daily habit."
For more details on study, you can follow the references...
It provides a brief information about Neuroplasticity to enthusiast willing to know "How we gain daily skills?" and "Changing ability of our brain according to our daily habit."
For more details on study, you can follow the references...
What is Neuroplasticity? What are neurons? Understand the Framework, Principles and types of Neuroplasticity. Learn about the mechanisms and processes of neuroplasticity. Understand the applications of neuroplasticity.
what is RNS and what the techniques to perform this test in the lab. Its significance in the evaluation and diagnosis of NMJ disorders like MG, LEMBS etc..
“The ability of neurons to change their function, chemical profile or structure is referred to as neuroplasticity.”
Neuroplasticity includes :
- Habituation
- Learning & memory
- Cellular recovery after injury
The neurophysiology of posture and movement. Its postural framework and CNS structures involved in the control of postural movement and postural reflexes. The influence of muscle tone on posture.
The ability of the neurons to change their function, chemical profile ( amount and types of neurotransmitters produced) or structure is referred to as neuroplasticity.
The plastic changes in neuron can occur
Physiologically according to activity and skill.
Pathologically due to injury or disease of CNS.
What is Neuroplasticity? What are neurons? Understand the Framework, Principles and types of Neuroplasticity. Learn about the mechanisms and processes of neuroplasticity. Understand the applications of neuroplasticity.
what is RNS and what the techniques to perform this test in the lab. Its significance in the evaluation and diagnosis of NMJ disorders like MG, LEMBS etc..
“The ability of neurons to change their function, chemical profile or structure is referred to as neuroplasticity.”
Neuroplasticity includes :
- Habituation
- Learning & memory
- Cellular recovery after injury
The neurophysiology of posture and movement. Its postural framework and CNS structures involved in the control of postural movement and postural reflexes. The influence of muscle tone on posture.
The ability of the neurons to change their function, chemical profile ( amount and types of neurotransmitters produced) or structure is referred to as neuroplasticity.
The plastic changes in neuron can occur
Physiologically according to activity and skill.
Pathologically due to injury or disease of CNS.
A review of recent evidences for macroscopic reorganisation from in vivo imaging studies. This presentation focuses on the neuroplastic changes of white matter and the possible mechanisms behind this.
Our goal is to connect the knowledge base from cognitive development and neuroscience to practical knowledge about learning and teaching in educational environments. Grounding learning and teaching in research about learning, we have discovered a universal scale for learning – which greatly increases the power of assessments and makes possible the use of a common toolkit for learning sequences in any domain. In addition, we have been able to design on-line computer-based assessments that make assessment both less expensive and more convenient. The tests start with assessments that are connected to learning environments and can be used directly to promote and guide learning. Our goal is to move beyond using tests as sorting mechanisms and toward using them as powerful aids for education.
Mindfulness & Grief: The Transformative Power of NowHeather Stang
The practice of mindfulness can help bereaved people calm their mind, relax their body, and make meaning from their loss. Learn how three members of an 8-week Yoga for Grief group found refuge in the present moment, tapped into their “Buddha Nature,” and used mindfulness meditation, journaling and the principles of Buddhist psychology to: practice compassion and forgiveness for the self and others; use skillful means to cope with the dual process of grief; gain insight into their natural wisdom and resilience; continue the legacy of their loved one; and improve their own physical health and increase self-efficacy.
[These slides are from Heather Stang’s presentation at the Association of Death Education and Counseling 36th Annual Conference in Baltimore, MD in April, 2014. Additional information on how to structure an 8 Week Mindfulness & Grief Group may be found at https://www.youtube.com/watch?v=BDBJGtrGc_s.]
Objectives:
1. Illustrate the parallels between the ancient principles of Buddhist psychology and how they relate to modern theories of thanatology.
2. Explain how the mindfulness practices present moment awareness and compassion which can be used to relieve physical and emotional suffering.
3. Review case studies that illustrate how the practice of mindfulness meditation and yoga contributes to meaning making and posttraumatic growth.
References:
Stang, H. (2014). Mindfuness and grief. London:CICO Books. http://amzn.to/1gJXqKH
Wada, K., & Park, J. (2009). Integrating Buddhist psychology into grief counseling. Death Studies, 37(7), 657-683.
Brach, T. (2012). True refuge: Finding peace and freedom in your own awakened heart. New York: Bantam Books.
Cacciatore, J., & Flint, M. (2012). ATTEND: Toward a mindfulness-based bereavement care model. Death Studies, 36(1), 61-82.
Rinpoche, S., Gaffney, P., & Harvey, A. (1992). The Tibetan book of living and dying. San Francisco: Harper San Francisco.
Heather Stang, MA is the author of Mindfulness and Grief, a book based on the 8 week groups she developed. She earned a Masters in Thanatology (Death, Dying & Bereavement) from Hood College in 2010, and is a mindfulness meditation instructor and Phoenix Rising Yoga Therapy practitioner at the Frederick Meditation Center. Her focus is on helping the bereaved stay healthy and increase immune functioning through mindfulness based practices, relaxation and expressive arts.
An introduction to the concept of neuroplasticity, and some examples of how technology (such as the internet, mobile technology and social media) is rewiring our brains.
Can adults really 'train their brains'? Brain Fitness capitalizes on neuroplasticity, the ability for a brain to rewire itself when experiencing something novel and non-routine. Programs like Luminosity, PositScience, and HAPPYneutron encapsulate the science behind enhancing memory, attention, reasoning, visual-spatial awareness, and language in fun, engaging games. This powerpoint explores the background of neuroplasticity and brain fitness and gives an overview of most popular brain exercises.
The term ‘cerebral palsy’ includes a group of disorders that result from permanent non-progressive brain damage during early development and are characterized by abnormalities of movement and posture.
a little dated, about 5 years, but still a great starting point for those interested in performance or rehab of the athlete's lumbar spine, more to come!
a little dated, about 5 years, but still a great starting point for anyone interested in performance or rehab of the Lumbar Spine. More to come. the plural of data is not anecdotes!
EFFECT OF MIRROR THERAPY ON UPPER EXTREMITY MOTOR FUNCTION IN STROKE PATIENTSismailabinji
EFFECT OF MIRROR THERAPY ON UPPER EXTREMITY MOTOR FUNCTION IN STROKE PATIENTS
Stroke is one of the main causes of disability around the globe. plegia (complete paralysis) or paresis (partial weakness ) are common following a stroke. According to the Journal of Physical Therapy Science, about 85 percent of stroke survivors will suffer from hemiplegia, and at least 69 percent will experience a loss of motor function in the upper limb.
Although these changes may not be permanent, some people regain partial or full limb function, the road to recovery can be long. But did you know that it is possible to trick the brain into believing what it sees? Mirror therapy is being used more and more in stroke rehabilitation to dupe the brain and restore limb function.
STROKE: is defined as the rapidly developed clinical signs of global or focal disturbance of cerebral function, lasting more than 24 hours or leading to death, with no apparent cause other than of vascular origin. (WHO, 2017)
MOTOR FUNCTION motor function is the ability to learn or to demonstrate the skillful and efficient assumption, maintenance, modification, and control of voluntary postures and movement patterns.
In mirror therapy, a mirror is placed beside the unaffected limb, blocking the view of the affected limb. This creates the illusion that both limbs are functioning properly.
Mirror theory is based on evidence that action observation activates the same motor areas of the brain as action execution. Observed actions lead to the generation of intended actions, engaging motor planning and execution.
Mirror neurons are type of brain cell that respond equally when we perform an action and when we witness someone else perform the same action. They were first discovered in the early 1990s, when a team of Italian researchers found individual neurons in the brains of macaque monkeys that fired both when the monkeys grabbed an object and also when the monkeys watched another primate grab the same object.
Patient characteristics
Motor abilities
Vision
Trunk control
Non affected limb
Cognitive abilities (Wade DT et al., 2011)
Informing the patient
Possible Negative effect
Environment and required materials
Surrounding
Jewellery and other marks
Mirror
pediatric electrodiagnostic for cerebral palsy,
A diagnosis of CP is often made based on MRI, delay of motor milestones and the presence of gait abnormalities in young children
Although the initial brain injury is non-progressive, the musculoskeletal impairments and functional limitations associated with CP are progressive
Three main classes of CP include spastic, dyskinetic and ataxic
Bangladesh bicycle ride for shaping up tomorrowLMRF
Four months ago, Two brave cyclists started rolling their paddles from Chittagong with a mission of travelling all over Bangladesh on bicycle create a mass awareness on two congenital deformities that LMRF is trying to eliminate since 2001 - Cleft Lip/Palate & Clubfoot.
Starting from 6th December 2014, they traveled 3500+ km, 64 districts in 127 days and finally they ended this journey of their lifetime in Dhaka on 12th April 2015. Shariful Islam Heron and Baharul Islam are the heros who showed extreme level of courage and determination to take awareness on these deformities to a new height and spread out our slogan - Shaping Up Tomorrow.
Journey Towards a Brighter Future with a Better SmileLMRF
Lion Mukhlesur Rahman Plastic Surgery Hospital Established on 2005 with the vision of eliminating Cleft lip and palate deformity from Bangladesh. It was one of a kind 20 bedded hospital that time in Chittagong, Bangladesh.
Ponseti Management of Clubfoot in Chittagong Division: Experience of 1000 Clu...LMRF
The aim of this study is to evaluate the effectiveness of the Ponseti method in children presenting before 5 years of age with either untreated or complex (initially treated unsuccessfully by other conservative methods) idiopathic clubfeet
Type of study : Retrospective clinical study.
Duration of study : From February 2010 to November 2011 (21months)
Place of study : 6 ZCF clinics of Chittagong, Cox’s bazar, Khagrachhari, Comilla, Noakhali & Chandpur.
Study population : Patients with CTEV attended at these ZCF clinics.
Treatment of congenital club foot by ponseti technique is very effective method with excellent result for below 1 years children.
Brace follow up is essential for long term better outcome.
With proper monitoring and support, Ponseti service can be effectively and successfully administered in a district general hospitals.
LMRF - Future Past in Childhood disability and developmentLMRF
Lion Mukhlesur Rahman Foundation was established in 2001 with the purpose of providing free cleft lip/palate surgery and rehabilitation. It was the first such organization in the Chittagong to provide such services. From its earliest days, LMRF has been primarily focused on providing out-of-the box healthcare services to the marginalized communities. Moreover, the services continue to be free of cost.
Twelve years since it has been established, LMRF today has transformed into an organization that primarily deals with children. After 2010, free of cost Clubfoot treatments have also been included and since then LMRF is the only organization that provides such service in the entire Chittagong division.
Based on today’s context and the needs of the future, over the next few years, LMRF intends to position itself as the most recognized children’s charity in Chittagong and Bangladesh. With this mission, LMRF introduces its flagship initiative – SHAPING UP TOMORROW.
A. Vision 2020 – Shaping Up Tomorrow
Lion Mukhlesur Rahman Foundation (LMRF) wants to be recognized as the Most Productive, Cost-Effective and leading children’s charity of Bangladesh with a manifesto of ensuring that every child gets the opportunity to grow up to the best of their potential without any barriers (physical, mental and social).
B. Purpose and Values:
This vision is driven by the idea that all under-privileged children born with physical, develompemtal and psyco-social barriers, bear equal potential to be a bright future for the country, if they are given a chance.
Our strengths lie in the disciplined delivery of quality health care and community effort to eliminate childhood problems and disabilities and continuous thrive for innovation in healthcare service to bring miracle in the lives of these needy children.
C. Mission for 2014 - 16
In 2014, LMRF will begin establishing the building blocks of Shaping Up Tomorrow. This includes strengthening existing projects, building teams to carry the vision, building infrastructure to support the intended growth and most importantly establish a secure funding strategy to become a high quality child development & rehabilitation organization by 2016 and carry towards the Shaping Up Tomorrow vision.
Clubfoot & Cleft lip programs of LMRF in BangladeshLMRF
Lion Mukhlesur Rahman Foundation (LMRF)
There are millions of children in Bangladesh who are suffering from congenital and aquired physical problems that can be solved through timely, effective and inexpensive treatment or surgeries. Regardless of the severity, children afflicted with various physial deformities like Facial clefts, clubfoot etc., face a life of disability with all its limitations. Lion Mukhlesur Rahman Foundation (LMRF) is a children’s charity organization, envision a society where children with inborn or acquired disability are detected, cured and rehabilitated early so that they can live a full, productive life. LMRF established a full free health service through her CureCleft & Zero Clubfoot projects for these unfortunate children of Bangladesh. By the skilled hands of our devoted Surgeons and Physiotherapists, 4300+ Cleft lip & palate and 2100+ children relieved from clubfoot deformity so far.
Awareness buildup: We conduct regular training program to Govt. health workers specially vaccination & family planning staffs, meet with Govt. doctors and arrange FGD with local NGO workers, beneficiary parents to aware about clefts & clubfoot problem. Publicity by regular poster sticking, leaflet, brochure newsletter distribution is a part of our continued awareness campaign.
Conclution: People are pivotal resource of our country and today’s children are our future. These underprevelaged children born with physical disabilities bear equal potential to be a bright future for the country, if they‘ve given a chance. LMRF has started a journey of hope to bring miracle to the lives of these needy children and shape up the future of Bangladesh.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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1. Neuroplasticity
Key to recovery after
spinal cord injury
Presented by : Dr. Shamim Khan
RMO, Medical Care Services
CRP, SAVAR
2. Classification of SCI
According to cause : According to site of injury :
– Traumatic – Cervical (tetraplegia)
• Fall from height – Dorsolumber (paraplegia)
• Fall while carrying heavy
load
• Fall of heavy object
• RTA, assault etc.
– Nontraumatic
• Tubercular spondylitis
• Pyogenic spondylitis
• Spinal cord tumour
• Transverse myelitis
• GBS
3. Classification of SCI (cont.)
According to ASIA impairment scale
Complete (A) Incomplete (B to E)
4. Spinal shock
This is a time period after the transection of the
spinal cord during which all the spinal reflex
responses are profoundly depressed.
Duration : Minimum 2 weeks
Bulbocavernous reflex : First reflex to appear
following recovery of spinal shock.
5. Cellular mechanism of SCI
Primary injury :
– Membrane dysruption
– Vascular damage
– Heamorrhage & edema.
– Ischemia (lack of O2)
Secondary injury :
– Chemical mediators released
by activated macrophage and
glial cells
– Prolonged inflammation and
scarring.
– Neural cell death and
neurological damage.
6. Why SCI is an irreversible lesion?
Once injured, CNS neurons
cannot regenerate their axons,
because :
– Lack of NGF.
– Inhibition of growth by
Oligodendrocytes.
– Clean up activities of
lymphocytes and Microglia.
– Increased GABAergic and
Glycinergic inhibition of spinal
networks.
7. Neuroplasticity
The ability of the neurons to change their
function, chemical profile ( amount and types
of neurotransmitters produced) or structure is
referred to as neuroplasticity.
The plastic changes in neuron can occur
– Physiologically according to activity and skill.
– Pathologically due to injury or disease of CNS.
11. Mechanism of Neuroplasticity
in CNS after an injury
Acute reorganization
– Unmasking of
previously present latent
synapses.
Chronic reorganization
– Changes in synaptic
efficacy.
– Growth of new synapses
by axonal sprouting.
These plasticity changes in CNS
can occur at multiple levels like
cerebral cortex, brain stem and
spinal cord.
12. Cortical Plasticity
Structural and functional reorganization of
cortical representation following injury is
known as cortical plasticity.
Cortical plasticity can occur after :
– CNS injury (stroke, SCI)
– Loss of a body part (amputation of limb or digit).
Changes in cortical map depends on :
– Spared connections available.
– Post injury survival time.
13. Cortical plasticity after
arm amputation
In a person with a missing upper limb fMRI and TMS
study on somatosensory cortex shows the hand area
becomes reorganized for representation of the face.
14. Cortical plasticity in paraplegic patients
In a complete paraplegic
patient after six months or
more, extensive use of hands
with least or no leg
movements results in plastic
invasion of cortical hand area
on the leg area.
PET scan study demonstrated
extension of cortical hand
map into the cortical leg map.
15. Cortical plasticity in paraplegic
patients (cont.)
By this way, the upper
limb gain strength and
lower limbs lose the
chance of functional
recovery.
And the patient
becomes wheelchair
bound forever !!
16. Cortical plasticity
Is it desirable or degradable ?
It is desirable in a sense that, increased strength and
function of the upperlimbs of paraplegic pt can
compensate the weekness of lower limbs for
locomotion, bed transfer etc.
It is degradable, because it weakens the chance of
lower limbs locomotor recovery.
17. Plasticity in transected spinal cord
Reorganization of severed descending pathways of
spinal cord can occur over time, and with the aid of
regenerative strategies.
1. Regeneration from the
severed fibre to the
original target.
2. Regeneration through a
haphazard pathway.
3. Sprouting from
neighbouring fibres onto
the denervated target
neuron.
4. Enhanced intrinsic
plasticity through
sensory feedback
training.
18. Plasticity in spinal pathways
Role of sensory feedback training
Studies of spinal reflex
conditioning states that,
repeated cutaneous or
electrical stimulation on
paralysed lower limbs
can enhance motor
response by changing
synaptic efficacy along
the spinal reflex arc.
19. Motor tasks can be learned by
spinal cord after transection
Can sensory feedback training help spinal cord to
acquire the ability to perform complex motor
activity, like walking or stepping?
Several studies on complete thoracic spinal
transected cat trained on treadmill for
locomotion resulted full weight-bearing stepping.
The spinal cord is able to integrate and adapt to
sensory information during locomotor training
and in response to sensory feedback, spinal
neurons learn to generate stepping in absence of
supraspinal input.
20. Can a complete spinal
transected human walk again ?
Studies states that, if only 10% of descending
spinal tacts are spared, some voluntary control
of locomotion can be recovered.
Task specific locomotor training triggers spinal
cord’s central pattern generator that can
sustain lower-limb repetitive movement
(walking), independent of direct brain control.
21. Strategies to enhance
recovery of locomotion
Body weight supported treadmill training
(BWST).
Pharmacological interventions.
Biotechnology to regenerate spinal connectivity.
22. Body weight supported
treadmill training (BWST)
About 50% of patients
body weight is suspended
in a harness.
Therapists manually assist
his legs to step on a slowly
moving treadmill.
The aim is to gradually
achieve full weight-
bearing at increasing
treadmill velocities.
23. BWST !! Light at the end of tunnel
Of acutely injured paitents 92% who used wheelchairs became
independent walkers after treadmill training.
Researcher No. of Durationof Training Result
subjects injury period %improved Extent
Dr. Anton 44 6 months 3 – 20 wks 36 indepen
Wernig(1995) – 18 yrs dent
Dr. A. L. 14 1.2 – 24 12 – 15
Hicks(2005) yrs months
Dr. Marcus 20 2-17 yrs 8 wks
Wirz (2005)
24. Pharmacological intervention
to improve stepping after SCI
Clonidine, a noradrenergic agonist.
Bicuculline, a GABA antagonist.
Strychnine, a glycinergic receptor
antagonist.
Cyproheptadine, a serotonergic
antagonist.
25. Molecular Biology and Biotechnology
to regenerate spinal connectivity
Peripheral nerve grafting.
Transplantation of fetal nervous tissue.
Administration of antibodies that block
growth inhibiting protein activity.
Implantation of engineered cells.
26. Role of Surgical Decompression
and Stabilization
Early decompression should be performed to
remove the tissue debris, bone and disc that
compress the spinal cord to alleviate pressure
and to improve the circulation of blood and
cerebrospinal fluid.
Some Studies demonstrate that the longer
compression of the spinal cord exists, the worse
the prognosis for neurological recovery.
Stabilization is obvious for discoligamentus
unstable spinal fractures.
Early stabilization allows early mobilization and
locomotor training.
Reduce chance of developing pressure sore,
postural hypotension and local pain.
Reduce hospital staying period, so reduced
chance of acquired infections.