title: Locomotor training: as a treatment of spinal cord injury and in the progression of neurologic rehabilitation.
abstract: Scientists, clinicians, administrators, individuals with spinal cord injury (SCI), and caregivers seek a common goal: to improve the outlook and general expectations of the adults and children living with neurologic injury. Important strides have already been accomplished; in fact, some have labeled the changes in neurologic rehabilitation a "paradigm shift." Not only do we recognize the potential of the damaged nervous system, but we also see that "recovery" can and should be valued and defined broadly. Quality-of-life measures and the individual's sense of accomplishment and well-being are now considered important factors. The ongoing challenge from research to clinical translation is the fine line between scientific uncertainty (ie, the tenet that nothing is ever proven) and the necessary burden of proof required by the clinical community. We review the current state of a specific SCI rehabilitation intervention (locomotor training), which has been shown to be efficacious although thoroughly debated, and summarize the findings from a multicenter collaboration, the Christopher and Dana Reeve Foundation's NeuroRecovery Network.
authors.affiliation: Department of Neurological Surgery, Kentucky Spinal Cord Research Center, University of Louisville, Louisville, KY, USA. susan.harkema@jhsmh.org
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Harkema
authors.forename: Jessica
authors.initials: J
authors.lastname: Hillyer
authors.forename: Mary
authors.initials: M
authors.lastname: Schmidt-Read
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ardolino
authors.forename: Sue Ann
authors.initials: SA
authors.lastname: Sisto
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Behrman
mesh_terms: D002986:Clinical Trials as Topic; D005081:Exercise Therapy / Q000379:methods*; D005684:Gait; D006801:Humans; D017063:Outcome Assessment, Health Care; D004856:Postural Balance; D011788:Quality of Life; D020127:Recovery of Function; D013119:Spinal Cord Injuries / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D016138:Walking