Coordination training in individuals with incomplete spinal cord injury: consideration of motor hierarchical structures.
METHODS
Clinical commentary.


OBJECTIVE
To discuss the method of coordination training to enhance motor skills in persons after spinal cord injury (SCI).


METHODS
From the literature and clinical experience, we learn that basic motor skills like walking are refined and maintained through the millions of repetitions that take place as part of normal development. These coordinated patterns function effectively as a form of training to the system because of the presence of neural pathways that mediate commands between higher and lower levels of the central nervous system (CNS). When these pathways are disrupted as a result of a lesion, the question that arises is whether retraining can be effective.


CONCLUSIONS
The question is directed at the common practice among rehabilitation professionals to prescribe and carry out tireless repetitions of coordinated motor activities in people with SCI lesions. We discuss this fundamental question from the perspective of understanding differences in maturation and function of higher motor centres and lower motor centres.
Kakebeeke
T H
TH
Institute for Clinical Research, Swiss Paraplegic Centre, Nottwil, Switzerland.
Roy
S H
SH
Largo
R H
RH
D002490:Central Nervous System / Q000503:physiopathology; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology; D009043:Motor Activity; D009048:Motor Skills; D011597:Psychomotor Performance; D012046:Rehabilitation / Q000193:education / Q000379:methods; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000534:rehabilitation*; D016138:Walking