title: Changes in supraspinal activation patterns following robotic locomotor therapy in motor-incomplete spinal cord injury.
abstract: OBJECTIVE
  Body weight-supported treadmill training (BWSTT) is a task-specific rehabilitation strategy that enhances functional locomotion in patients following spinal cord injury (SCI). Supraspinal centers may play an important role in the recovery of over-ground locomotor function in patients with motor-incomplete SCI. The purpose of this study was to evaluate the potential for supraspinal reorganization associated with 12 weeks of robotic BWSTT using functional magnetic resonance imaging (fMRI).
  
  
  METHODS
  Four men with motor-incomplete SCI participated in this study. Time since onset ranged from 14 weeks to 48 months post-SCI injury. All subjects were trained with BWSTT 3 times weekly for 12 weeks. This training was preceded and followed by fMRI study of supraspinal activity during a movement task. Testing of locomotor disability included the Walking Index for Spinal Cord Injury (WISCI II) and over-ground gait speed.
  
  
  RESULTS
  All subjects demonstrated some degree of change in the blood-oxygen-level-dependent (BOLD) signal following BWSTT. fMRI results demonstrated greater activation in sensorimotor cortical regions (S1, S2) and cerebellar regions following BWSTT.
  
  
  CONCLUSIONS
  Intensive task-specific rehabilitative training, such as robotic BWSTT, can promote supraspinal plasticity in the motor centers known to be involved in locomotion. Furthermore, improvement in over-ground locomotion is accompanied by an increased activation of the cerebellum.
authors.affiliation: University of Texas Southwestern Medical Center, Department of Physical Therapy, Dallas, TX 75390-8876, USA. patricia.winchester@utsouthwestern.edu
authors.forename: Patricia
authors.initials: P
authors.lastname: Winchester
authors.forename: Roderick
authors.initials: R
authors.lastname: McColl
authors.forename: Ross
authors.initials: R
authors.lastname: Querry
authors.forename: Nathan
authors.initials: N
authors.lastname: Foreman
authors.forename: James
authors.initials: J
authors.lastname: Mosby
authors.forename: Keith
authors.initials: K
authors.lastname: Tansey
authors.forename: Jon
authors.initials: J
authors.lastname: Williamson
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology / Q000503:physiopathology*; D005528:Foot / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D011403:Pronation / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology; D012371:Robotics; D013119:Spinal Cord Injuries / Q000150:complications* / Q000503:physiopathology; D013484:Supination / Q000502:physiology; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*