The role of rehabilitation and methodological problems in spinal cord repair therapies.
Despite the rapid development of studies of spinal cord repair therapies (SCRT), there is still a dearth of reliable reports on their clinical usefulness. Basing on a review of current literature, this article emphasises the role and special character of comprehensive rehabilitation based on the modulation of central nervous system plasticity in the treatment of spinal cord injuries with the use of SCRT. Basing on guidelines by the International Campaign for Cures of Spinal Cord Injury Paralysis (ICCP), this article also discusses ethical and methodological issues of SCRT studies. Comprehensive motor rehabilitation exerts an effect that potentially modifies spinal cord plasticity and may significantly supplement SCRT, leading to expected functional effects. Encouraging results of animal studies cannot be directly translated into expectations regarding SCRT utility people. Ensuring a high quality of studies on SCRT efficacy and safety necessitates compliance with rigorous methodological requirements. Functional ability of the patient needs to be a significant end-point of SCRT studies.
Tederko
Piotr
P
Rehabilitation Department, Medical University of Warsaw, Poland. pited@esculap.pl
Krasuski
Marek
M
Kiwerski
Jerzy
J
Nyka
Izabela
I
Białoszewski
Dariusz
D
D000818:Animals; D002986:Clinical Trials as Topic; D017408:Guidelines as Topic; D006801:Humans; D009416:Nerve Regeneration; D009473:Neuronal Plasticity; D019637:Orthopedic Procedures / Q000379:methods; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D012107:Research Design; D013119:Spinal Cord Injuries / Q000534:rehabilitation*